Provider Demographics
NPI:1295823573
Name:BECK, WOODROW WILSON JR (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:WOODROW
Middle Name:WILSON
Last Name:BECK
Suffix:JR
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 935
Mailing Address - Street 2:578 FARRINGDOM STREET
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358
Mailing Address - Country:US
Mailing Address - Phone:910-739-5751
Mailing Address - Fax:910-739-0522
Practice Address - Street 1:578 FARRINGDOM STREET
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358
Practice Address - Country:US
Practice Address - Phone:910-739-5751
Practice Address - Fax:910-739-0522
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC787111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
08265OtherBCBS
NC08265Medicaid
NC08265Medicaid