Provider Demographics
NPI:1700083136
Name:WOOD, ROY ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:ALLEN
Last Name:WOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:ALLEN
Other - Middle Name:
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3727 BUCHANAN ST
Mailing Address - Street 2:STE 203
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-1779
Mailing Address - Country:US
Mailing Address - Phone:415-563-1655
Mailing Address - Fax:
Practice Address - Street 1:3727 BUCHANAN ST
Practice Address - Street 2:STE 203
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-1779
Practice Address - Country:US
Practice Address - Phone:415-563-1655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20446111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician