Provider Demographics
NPI:1053163550
Name:WOODS, RAYMELL L
Entity type:Individual
Prefix:
First Name:RAYMELL
Middle Name:L
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 RAMBLEWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-4079
Mailing Address - Country:US
Mailing Address - Phone:216-396-4998
Mailing Address - Fax:
Practice Address - Street 1:1235 RAMBLEWOOD TRL
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4079
Practice Address - Country:US
Practice Address - Phone:216-396-4998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver