Provider Demographics
NPI:1205235264
Name:WOOD FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:WOOD FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-895-2225
Mailing Address - Street 1:205 N CHESTNUT ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LA CRESCENT
Mailing Address - State:MN
Mailing Address - Zip Code:55947-1280
Mailing Address - Country:US
Mailing Address - Phone:608-895-2225
Mailing Address - Fax:
Practice Address - Street 1:205 N CHESTNUT ST
Practice Address - Street 2:SUITE 108
Practice Address - City:LA CRESCENT
Practice Address - State:MN
Practice Address - Zip Code:55947-1280
Practice Address - Country:US
Practice Address - Phone:608-895-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization