Provider Demographics
NPI:1841670791
Name:WOODHULL-SMITH, BRITNEY ELISE (LAT, ATC)
Entity type:Individual
Prefix:
First Name:BRITNEY
Middle Name:ELISE
Last Name:WOODHULL-SMITH
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 ALL-AMERICAN DRIVE
Mailing Address - Street 2:STARNES ATHLETIC TRAINING ROOM
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38677
Mailing Address - Country:US
Mailing Address - Phone:662-915-7536
Mailing Address - Fax:
Practice Address - Street 1:836 ALL-AMERICAN DRIVE
Practice Address - Street 2:STARNES ATHLETIC TRAINING ROOM
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38677
Practice Address - Country:US
Practice Address - Phone:662-915-7536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSAT06982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer