Individual provider · NPI-1
Angela Woodruff, PTA
Health & Wellness Coach · Lansing, MI
NPI number1376930222
StatusActive
Last updated in NPPESNov 16, 2023
Details
- NPI
- 1376930222
- Entity type
- Individual (NPI-1)
- Name
- Angela Woodruff
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 17, 2015
- Certification date
- Nov 16, 2023
- Last updated
- Nov 16, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171400000X | Health & Wellness Coach | A-3659397 | MI | Yes |
| 225200000X | Physical Therapy Assistant | 5502003374 | MI |
Practice location
2100 E Provincial House DrLansing, MI 48910-4884
Phone 517-272-4029
Mailing address
2100 E Provincial House DrLansing, MI 48910-4884
Phone 517-272-4029
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