Provider Demographics
NPI:1922193945
Name:WOODRUFF PHYSICAL THERAPY
Entity Type:Organization
Organization Name:WOODRUFF PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOODRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-887-7800
Mailing Address - Street 1:4 HAVERHILL RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03036-4206
Mailing Address - Country:US
Mailing Address - Phone:603-887-7800
Mailing Address - Fax:603-887-7801
Practice Address - Street 1:4 HAVERHILL RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NH
Practice Address - Zip Code:03036-4206
Practice Address - Country:US
Practice Address - Phone:603-887-7800
Practice Address - Fax:603-887-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH50Y544700NH01OtherANTHEM
NH=========0008OtherCIGNA