Individual
JASON WOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1100 CLUB VILLAGE DR STE 103, COLUMBIA, MO 65203-4411
(573) 256-2777
Mailing address
103 DALE LN, CALIFORNIA, MO 65018-1158
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2013043081
MO
Other
Enumeration date
11/17/2014
Last updated
11/17/2014
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