Individual
JACOB DANIEL WOODARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1411 W BADDOUR PKWY, LEBANON, TN 37087-2513
(615) 444-8262
Mailing address
331 PIG BRANCH RD, BRUSH CREEK, TN 38547-5116
(615) 489-0621
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0000002113
TN
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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