Provider Demographics
NPI:1922453604
Name:WOODROOF, IKE (DC)
Entity Type:Individual
Prefix:DR
First Name:IKE
Middle Name:
Last Name:WOODROOF
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 1:1463 E 151ST ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-2854
Mailing Address - Country:US
Mailing Address - Phone:913-735-6351
Mailing Address - Fax:913-490-2898
Practice Address - Street 1:1463 E 151ST ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-2854
Practice Address - Country:US
Practice Address - Phone:913-735-6351
Practice Address - Fax:913-490-2898
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05791111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor