Individual
MR. COLTON ALLEN WOODWARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
47 MARGO AVE, BARDWELL, KY 42023-9005
(270) 628-5424
Mailing address
1316 OAKSHIRE RD, UNION CITY, TN 38261-8865
(731) 592-2968
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0000006627
TN
225X00000X
Occupational Therapist
Primary
266003
KY
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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