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Individual

LAURA T WOODWORTH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
2500 S HILL RD, GLADSTONE, MI 49837-2310
(906) 630-1293
(906) 428-2699
Mailing address
2500 S HILL RD, GLADSTONE, MI 49837-2310
(906) 630-1293
(906) 428-2699

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201000682
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5201000682
STATE OTRREGISTRATION NO
MI
Enumeration date
07/28/2005
Last updated
07/08/2007
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