Provider Demographics
NPI:1952675431
Name:WOODS, MORGAN KAYE WATERSTRAAT (DC)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:KAYE WATERSTRAAT
Last Name:WOODS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4926 42ND AVE N
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-1731
Mailing Address - Country:US
Mailing Address - Phone:763-537-3927
Mailing Address - Fax:763-537-1421
Practice Address - Street 1:4926 42ND AVE N
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-1731
Practice Address - Country:US
Practice Address - Phone:763-537-3927
Practice Address - Fax:763-537-1421
Is Sole Proprietor?:No
Enumeration Date:2012-03-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-1817111NP0017X
MN6126111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTM011003351Medicare PIN