Provider Demographics
NPI:1780821033
Name:WOODCOCK, LANDRA MICHELLE (AP)
Entity Type:Individual
Prefix:
First Name:LANDRA
Middle Name:MICHELLE
Last Name:WOODCOCK
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8259 47TH STREET CIRCLE EAST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221
Mailing Address - Country:US
Mailing Address - Phone:941-721-9582
Mailing Address - Fax:
Practice Address - Street 1:4055 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2549
Practice Address - Country:US
Practice Address - Phone:941-650-9345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2606171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist