Individual
THERESA WOODLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 25742, SANTA ANA, CA 92799-5742
(401) 636-3219
Mailing address
PO BOX 25742, SANTA ANA, CA 92799-5742
(401) 636-3219
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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