Provider Demographics
NPI:1053420711
Name:WOODS, ELISABETH AINSLIE (PT)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:AINSLIE
Last Name:WOODS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ELISABETH
Other - Middle Name:AINSLIE
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15102 STILLHOUSE CREEK
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017
Mailing Address - Country:US
Mailing Address - Phone:636-519-0760
Mailing Address - Fax:
Practice Address - Street 1:4850 LEMAY FERRY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-1576
Practice Address - Country:US
Practice Address - Phone:314-416-1707
Practice Address - Fax:314-416-7626
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO108176225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO217671509Medicare ID - Type Unspecified