Travis Lee Woolridge

NPI #1407500788 in Wagoner, Oklahoma

Provider Information

NPI Number: 1407500788
Entity Type: Individual
Name: Travis Lee Woolridge
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Feb 7, 2022
Last Updated: Feb 7, 2022

Practice Location

Address: 109 S HARRILL AVE
City: Wagoner
State: Oklahoma
ZIP Code: 74467-5317
Phone: (573) 473-7504

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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