Provider Demographics
NPI:1396823407
Name:WOODWARD, MARGARET ERICKSON (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ERICKSON
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3801
Mailing Address - Country:US
Mailing Address - Phone:303-300-6842
Mailing Address - Fax:303-758-1260
Practice Address - Street 1:1776 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3801
Practice Address - Country:US
Practice Address - Phone:303-300-6842
Practice Address - Fax:303-758-1260
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4746225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC24863Medicare ID - Type Unspecified