Organization
US ARMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA WOOLRIDGE DPT (PHYSICAL THERAPIST)
(719) 649-3947
Entity
Organization
Contact information
Practice address
8800 MAIN ST, APT 408C, FORT DRUM, NY 13603-2159
(719) 649-3947
Mailing address
8800 MAIN ST, APT 408C, FORT DRUM, NY 13603-2159
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PTL0012834
CO
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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