Provider Demographics
NPI:1558533471
Name:WOODS CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:WOODS CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-257-3919
Mailing Address - Street 1:8509 WESTFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-2369
Mailing Address - Country:US
Mailing Address - Phone:317-257-3919
Mailing Address - Fax:317-257-3919
Practice Address - Street 1:8509 WESTFIELD BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-2369
Practice Address - Country:US
Practice Address - Phone:317-257-3919
Practice Address - Fax:317-257-3919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001962A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000298226OtherANTHEM
IN221150Medicare Oscar/Certification
IN83597Medicare UPIN