Provider Demographics
NPI:1023319779
Name:WOODMANSEE, ELLIOTT SHAWN (DC)
Entity type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:SHAWN
Last Name:WOODMANSEE
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 1:750 W DIMOND BLVD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1501
Mailing Address - Country:US
Mailing Address - Phone:907-344-0033
Mailing Address - Fax:907-344-6332
Practice Address - Street 1:750 W DIMOND BLVD
Practice Address - Street 2:SUITE 121
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1501
Practice Address - Country:US
Practice Address - Phone:907-344-0033
Practice Address - Fax:907-344-6332
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK522111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor