Provider Demographics
NPI:1316452048
Name:WOODS, MINH-TAM LE (DPT)
Entity type:Individual
Prefix:
First Name:MINH-TAM
Middle Name:LE
Last Name:WOODS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MINH-TAM
Other - Middle Name:LE
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:73 NEWTON RD UNIT 101
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2440
Mailing Address - Country:US
Mailing Address - Phone:978-388-7272
Mailing Address - Fax:978-388-7373
Practice Address - Street 1:541 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1857
Practice Address - Country:US
Practice Address - Phone:781-340-1480
Practice Address - Fax:781-340-1481
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305213510225100000X
TN225100000X
TN13106225100000X
MA23390225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ029723Medicaid