Provider Demographics
NPI:1396758991
Name:WOODRUFF FAMILY CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:WOODRUFF FAMILY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:RAND
Authorized Official - Last Name:WOODRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-786-5288
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:4556 SALLING AVE
Mailing Address - City:LEWISTON
Mailing Address - State:MI
Mailing Address - Zip Code:49756
Mailing Address - Country:US
Mailing Address - Phone:989-786-5288
Mailing Address - Fax:989-786-7349
Practice Address - Street 1:4556 SALLING AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:MI
Practice Address - Zip Code:49756
Practice Address - Country:US
Practice Address - Phone:989-786-5288
Practice Address - Fax:989-786-7349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty