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Individual

MR. BRENT L WOODBURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
6700 N FIRST ST, SUITE 105, FRESNO, CA 93710
(559) 431-0757
(559) 431-0758
Mailing address
6700 N FIRST ST, SUITE 105, FRESNO, CA 93710
(559) 431-0757
(559) 431-0758

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2222
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E22220
CA
Enumeration date
12/27/2006
Last updated
07/08/2007
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