Provider Demographics
NPI: | 1942988423 |
---|---|
Name: | WOOLRIDGE, MICHAEL O'CONNER (RRT, CPFT) |
Entity Type: | Individual |
Prefix: | MR |
First Name: | MICHAEL |
Middle Name: | O'CONNER |
Last Name: | WOOLRIDGE |
Suffix: | |
Gender: | M |
Credentials: | RRT, CPFT |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1201 BROAD ROCK BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | RICHMOND |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 23249-0001 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 804-675-5000 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1201 BROAD ROCK BLVD |
Practice Address - Street 2: | |
Practice Address - City: | RICHMOND |
Practice Address - State: | VA |
Practice Address - Zip Code: | 23249-0001 |
Practice Address - Country: | US |
Practice Address - Phone: | 804-675-5000 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2023-07-06 |
Last Update Date: | 2023-07-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | 227900000X, 2279C0205X, 2279E0002X, 2279G1100X, 2279H0200X, 2279P1006X | |
227900000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2279P1006X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Pulmonary Function Technologist |
No | 227900000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | |
No | 2279C0205X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Critical Care |
No | 2279E0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Emergency Care |
No | 2279G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | General Care |
No | 2279H0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Home Health |