Provider Demographics
NPI:1699371039
Name:WOODS, BRIAN J (MA)
Entity Type:Individual
Prefix:PROF
First Name:BRIAN
Middle Name:J
Last Name:WOODS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 N HAWKINS AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5663
Mailing Address - Country:US
Mailing Address - Phone:330-869-0815
Mailing Address - Fax:
Practice Address - Street 1:584 N HAWKINS AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-5663
Practice Address - Country:US
Practice Address - Phone:330-869-0815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver