Provider Demographics
NPI:1740316686
Name:WOODS, JAMES PASCO (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PASCO
Last Name:WOODS
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 1:2435 KIMBERLY RD STE 165S
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3591
Mailing Address - Country:US
Mailing Address - Phone:563-355-9330
Mailing Address - Fax:562-411-2898
Practice Address - Street 1:2435 KIMBERLY RD STE 165S
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3591
Practice Address - Country:US
Practice Address - Phone:563-355-9330
Practice Address - Fax:562-411-2898
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04306111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0097558Medicaid
IA0097558Medicaid
IA09400Medicare ID - Type Unspecified