Provider Demographics
NPI:1417266917
Name:WOODHALL, ROBERT SCOTT (DC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:SCOTT
Last Name:WOODHALL
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 1:13002 CHANCES R RD
Mailing Address - Street 2:
Mailing Address - City:PENN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95946-9435
Mailing Address - Country:US
Mailing Address - Phone:530-273-7988
Mailing Address - Fax:530-273-7993
Practice Address - Street 1:227 COLFAX AVE
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-6843
Practice Address - Country:US
Practice Address - Phone:530-273-7988
Practice Address - Fax:530-273-7993
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor