Provider Demographics
NPI:1518325588
Name:WOODS-OSIFO, MARYANN JEWEL (DC)
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:JEWEL
Last Name:WOODS-OSIFO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1780 W MCDERMOTT DR
Mailing Address - Street 2:STE 200
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3361
Mailing Address - Country:US
Mailing Address - Phone:972-954-1470
Mailing Address - Fax:469-656-3808
Practice Address - Street 1:1780 W MCDERMOTT DR
Practice Address - Street 2:STE 200
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3361
Practice Address - Country:US
Practice Address - Phone:972-954-1470
Practice Address - Fax:469-656-3808
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX12884111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor