Provider Demographics
NPI:1689798902
Name:WOODS, KATHERINA L (DC)
Entity Type:Individual
Prefix:
First Name:KATHERINA
Middle Name:L
Last Name:WOODS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2614 E 13TH AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2369
Mailing Address - Country:US
Mailing Address - Phone:303-358-5217
Mailing Address - Fax:303-322-0188
Practice Address - Street 1:2614 E 13TH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-2369
Practice Address - Country:US
Practice Address - Phone:303-358-5217
Practice Address - Fax:303-322-0188
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5450111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU94783Medicare UPIN
COC494408Medicare ID - Type Unspecified