Provider Demographics
NPI:1134661291
Name:WOODS, KAYLA (ATC/LAT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:ATC/LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9493 KELLEY FARM RD
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-7008
Mailing Address - Country:US
Mailing Address - Phone:334-488-1199
Mailing Address - Fax:
Practice Address - Street 1:9493 KELLEY FARM RD
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-7008
Practice Address - Country:US
Practice Address - Phone:334-488-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0030662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer