Provider Demographics
NPI:1881753648
Name:ROBERT L. WOODEN D.C., P.C.
Entity type:Organization
Organization Name:ROBERT L. WOODEN D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:WOODEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-968-4642
Mailing Address - Street 1:3200 S RURAL RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-3870
Mailing Address - Country:US
Mailing Address - Phone:480-968-4642
Mailing Address - Fax:480-966-1526
Practice Address - Street 1:3200 S RURAL RD
Practice Address - Street 2:SUITE 3
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-3870
Practice Address - Country:US
Practice Address - Phone:480-968-4642
Practice Address - Fax:480-966-1526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2008-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ735111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty