Provider Demographics
NPI:1457463804
Name:WOODWARD, MICHAEL LEE (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LEE
Last Name:WOODWARD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4900 S ARROWHEAD DR
Mailing Address - Street 2:STE B
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-6990
Mailing Address - Country:US
Mailing Address - Phone:816-795-6999
Mailing Address - Fax:816-795-3366
Practice Address - Street 1:8700 STATE LINE RD
Practice Address - Street 2:STE 110
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66206-1569
Practice Address - Country:US
Practice Address - Phone:913-381-2388
Practice Address - Fax:913-381-5868
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-01-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS11-03626225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist