Provider Demographics
NPI:1043360720
Name:WOODRUFF, MATTHEW S (MS, ATC)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:S
Last Name:WOODRUFF
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2364 REDBUD DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48855-6410
Mailing Address - Country:US
Mailing Address - Phone:517-546-2112
Mailing Address - Fax:
Practice Address - Street 1:2364 REDBUD DR
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48855-6410
Practice Address - Country:US
Practice Address - Phone:517-546-2112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine