Individual
MRS. ELIZABETH WOOLAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1620 TIMBER WOLF DR, HOLLAND, OH 43528-8303
(419) 868-7378
(419) 868-7390
Mailing address
1620 TIMBER WOLF DR, HOLLAND, OH 43528-8303
(419) 868-7378
(419) 868-7390
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
03237
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0160617164
HEALTH CARE PROVIDERS
OH
01
—
1942200704
OWNER NPI
OH
01
—
34191273800
BWC #
OH
01
—
3419127380A00
ANTHEM BCBS PRACTICE #
OH
01
—
373805127-00
PARAMOUNT WC #
OH
01
—
373805127-002
MMOH #
OH
Enumeration date
03/02/2007
Last updated
05/26/2015
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