Individual
SAM WOODWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACSM EP
Contact information
Practice address
2160 W 86TH ST STE 101, INDIANAPOLIS, IN 46260-1908
(574) 215-2734
Mailing address
5136 N KENWOOD AVE, INDIANAPOLIS, IN 46208-2620
(574) 215-2734
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
—
IN
Other
Enumeration date
04/18/2022
Last updated
04/18/2022
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