Individual
MRS. CHRISTY KING WOODRUFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2880 W 5TH ST, GREENVILLE, NC 27834-6166
(252) 717-9668
(252) 321-0484
Mailing address
2880 W 5TH ST, GREENVILLE, NC 27834-6166
(252) 717-9668
(252) 321-0484
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2627
NC
225XP0200X
Pediatric Occupational Therapist
Primary
2627
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49358
BLUE CROSS BLUE SHIELD NC
NC
05
—
7349358
—
NC
Enumeration date
04/03/2006
Last updated
03/25/2021
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