Individual
MR. MATTHEW D WOODRUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOTR/L
Contact information
Practice address
5521 W STATE ST, BOISE, ID 83703-3337
(208) 853-6220
(208) 853-0554
Mailing address
3015 E MAGIC VIEW DR, STE 100, MERIDIAN, ID 83642-3750
(208) 853-6220
(208) 853-0554
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-765
ID
Other
Enumeration date
10/17/2008
Last updated
08/10/2018
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