Provider Demographics
NPI:1083773840
Name:WOODEN, ROBERT LOUIS (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LOUIS
Last Name:WOODEN
Suffix:
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 1:3200 S RURAL RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-3870
Mailing Address - Country:US
Mailing Address - Phone:480-968-4642
Mailing Address - Fax:480-966-1526
Practice Address - Street 1:3200 S RURAL RD
Practice Address - Street 2:SUITE 3
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-3870
Practice Address - Country:US
Practice Address - Phone:480-968-4642
Practice Address - Fax:480-966-1526
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ735111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor