Provider Demographics
NPI:1972820611
Name:WOODRUFF, LEAH F (PT)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:F
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-8847
Mailing Address - Country:US
Mailing Address - Phone:903-316-6001
Mailing Address - Fax:
Practice Address - Street 1:201 WINCHESTER DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-8847
Practice Address - Country:US
Practice Address - Phone:903-316-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1176643225100000X
TX142657174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist