NPI 1104255009

Matthew Woodruff

Practitioner Physical Therapist Brandon, MS

Practice location

Address: 359 Avalon Way, Brandon, MS 39047-7787
Phone: (662) 207-6756

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence PT4885 (MS)

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Registry record

NPI: 1104255009
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Nov 2013
Record last updated: 1 Nov 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.