Provider Demographics
NPI:1720157811
Name:WOODS, RHONDA ZAE (DC)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:ZAE
Last Name:WOODS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 E OHIO ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-5809
Mailing Address - Country:US
Mailing Address - Phone:605-343-4016
Mailing Address - Fax:
Practice Address - Street 1:621 E OHIO ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-5809
Practice Address - Country:US
Practice Address - Phone:605-343-4016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD809111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7600960Medicaid
SD0003170OtherBCBS OF SD
SD0003170OtherBCBS OF SD
SD7600960Medicaid