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Individual

DAMISHA WOODLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1133 BROOKE PARK DR, TOLEDO, OH 43612-4217
(419) 508-7249
Mailing address
1133 BROOKE PARK DR, TOLEDO, OH 43612-4217
(419) 508-7249

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
0183878
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0183878
OH
Enumeration date
07/28/2020
Last updated
07/28/2020
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