Provider Demographics
NPI:1063646883
Name:WOODS, RONNIE B JR (DC)
Entity Type:Individual
Prefix:DR
First Name:RONNIE
Middle Name:B
Last Name:WOODS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4167 W MUD CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:61054-9523
Mailing Address - Country:US
Mailing Address - Phone:815-734-7000
Mailing Address - Fax:815-734-7009
Practice Address - Street 1:4167 W MUD CREEK RD
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:IL
Practice Address - Zip Code:61054-9523
Practice Address - Country:US
Practice Address - Phone:815-734-7000
Practice Address - Fax:815-734-7009
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011417111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor