Provider Demographics
NPI:1538296884
Name:WOODS, NOEL SHANNON (DC)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:SHANNON
Last Name:WOODS
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 1:2435 KIMBERLY RD STE 165S
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3591
Mailing Address - Country:US
Mailing Address - Phone:563-355-9330
Mailing Address - Fax:
Practice Address - Street 1:2435 KIMBERLY RD STE 165S
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3591
Practice Address - Country:US
Practice Address - Phone:563-355-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06229111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0484949Medicaid
IA03670OtherWELLMARK BCBS OF IOWA
IA03670OtherWELLMARK BCBS OF IOWA