Provider Demographics
NPI:1609587351
Name:WOO, GARRETT THOMAS
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:THOMAS
Last Name:WOO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 HAROLD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-2028
Mailing Address - Country:US
Mailing Address - Phone:408-246-1738
Mailing Address - Fax:
Practice Address - Street 1:68 HAROLD AVE STE 101
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-2028
Practice Address - Country:US
Practice Address - Phone:408-246-1738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36399111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty