Provider Demographics
NPI:1215187323
Name:WOYWOOD CHIROPRACTIC WELLNESS, PA
Entity Type:Organization
Organization Name:WOYWOOD CHIROPRACTIC WELLNESS, PA
Other - Org Name:WOYWOOD INTEGRATED MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:WOYWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-646-9060
Mailing Address - Street 1:12702 TOEPPERWEIN RD STE 140
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3267
Mailing Address - Country:US
Mailing Address - Phone:210-646-9060
Mailing Address - Fax:210-646-6219
Practice Address - Street 1:12702 TOEPPERWEIN RD STE 140
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3267
Practice Address - Country:US
Practice Address - Phone:210-646-9060
Practice Address - Fax:210-646-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty