Individual
JACK TODD WOODRING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5611 GALLIA ST, PORTSMOUTH, OH 45662-5520
(740) 529-0083
Mailing address
5611 GALLIA ST, PORTSMOUTH, OH 45662-5520
(740) 529-0083
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
171184
OH
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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