Individual
JUDAH BENJAMIN WOODALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
605 POLKVILLE RD, SHELBY, NC 28150-2898
(803) 230-5487
Mailing address
605 POLKVILLE RD, SHELBY, NC 28150-2898
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/06/2019
Last updated
01/06/2019
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