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Individual

MRS. LARA K WOODARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
55 SGT PRENTISS DR, SUITE 8, NATCHEZ, MS 39120-4782
(601) 446-8764
(601) 446-8745
Mailing address
55 SGT PRENTISS DR, SUITE 8, NATCHEZ, MS 39120-4782
(601) 446-8764
(601) 446-8745

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3384
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01850075
MS
Enumeration date
10/17/2006
Last updated
05/15/2021
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