Individual
JOHN RANDALL WOODWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
421 EAST 300 SOUTH, OXFORD, IN 47971
(765) 884-1600
Mailing address
3001 S CREASY LN STE 100B, LAFAYETTE, IN 47905-5206
(765) 420-5800
(765) 423-6099
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003657A
IN
Other
Enumeration date
07/02/2020
Last updated
01/16/2024
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