Provider Demographics
NPI:1801014642
Name:WOODMAN, THOMAS J (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:WOODMAN
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 1:120 EAST AVE
Mailing Address - Street 2:SUITE 1WA
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5703
Mailing Address - Country:US
Mailing Address - Phone:203-316-8212
Mailing Address - Fax:203-348-6595
Practice Address - Street 1:120 EAST AVE
Practice Address - Street 2:SUITE 1WA
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5703
Practice Address - Country:US
Practice Address - Phone:203-316-8212
Practice Address - Fax:203-348-6595
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor