Provider Demographics
NPI:1891863205
Name:WOOD, JEFFERY ALLEN SR (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:ALLEN
Last Name:WOOD
Suffix:SR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4400 THE WOODS DR
Mailing Address - Street 2:#1523
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136-3844
Mailing Address - Country:US
Mailing Address - Phone:661-496-4334
Mailing Address - Fax:408-937-6363
Practice Address - Street 1:4400 THE WOODS DR
Practice Address - Street 2:#1523
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95136-3844
Practice Address - Country:US
Practice Address - Phone:661-496-4334
Practice Address - Fax:408-937-6363
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA23408111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician