Provider Demographics
NPI:1871688846
Name:WOODS, PHILLIP P (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:P
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 1:35 NORTH PORTER ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-1427
Mailing Address - Country:US
Mailing Address - Phone:724-852-1624
Mailing Address - Fax:724-852-1592
Practice Address - Street 1:35 NORTH PORTER ST
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-1427
Practice Address - Country:US
Practice Address - Phone:724-852-1624
Practice Address - Fax:724-852-1592
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007373L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA94018OtherUNISON
PA086311OtherBCBS
1017897OtherASHN
PA086311OtherBCBS
PA022632Medicare ID - Type Unspecified