Diana Lynn Woodiel, MS, PT

Individual provider Active NPI Pediatric Physical Therapist · Ward, AR

NPI 1356487243 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1356487243
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Physical Therapist 2251P0200X
License
2185 (AR)
Practice address
1500 Wilson Loop
Ward, AR 72176
Phone
(501) 941-5630
Fax
(501) 843-2270
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2185ARMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Therapy and Consulting Services, PA Past
since Apr 24, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 2185 AR Yes

Addresses

Primary practice location

1500 Wilson Loop
Ward, AR 72176

Mailing address

33 Lilac LN
Cabot, AR 72023-8182
Phone (501) 912-6401

Other identifiers

IdentifierTypeStateIssuer
5U634OtherARBLUE CROSS BLUE SHIELD

Other providers in Ward, AR

All providers in Ward, AR · Pediatric Physical Therapist in Arkansas

Sources for this page

Verify at the official NPI Registry.