Provider Demographics
NPI:1558486753
Name:WOODRUFF, JAMIE RENEE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:RENEE
Last Name:WOODRUFF
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 1:1125 SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:PA
Mailing Address - Zip Code:17847-7607
Mailing Address - Country:US
Mailing Address - Phone:570-742-7099
Mailing Address - Fax:570-742-6015
Practice Address - Street 1:1901 N 5TH ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-1510
Practice Address - Country:US
Practice Address - Phone:717-221-7900
Practice Address - Fax:717-221-7908
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006831L225100000X
VA2305003183225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist