Individual
MR. THOMAS GARY WOODCOCK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
260 PARK AVE, APT. 2003, POOLER, GA 31322-4266
(912) 441-7408
Mailing address
260 PARK AVE, APT. 2003, POOLER, GA 31322-4266
(912) 441-7408
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
0131001534
VA
224Z00000X
Occupational Therapy Assistant
Primary
OTA000583
GA
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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