Individual
TAMANTHA WOFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, ATC/L
Contact information
Practice address
7300 REINHARDT CIR, WALESKA, GA 30183-2981
(770) 720-9321
Mailing address
7300 REINHARDT CIR, WALESKA, GA 30183-2981
(770) 720-9321
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3963
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000004617
BOC ATHLETIC TRAINER
FL
Enumeration date
04/07/2015
Last updated
04/14/2016
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