Provider Demographics
NPI:1982892519
Name:WOOD, VINCENT A (DC)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:A
Last Name:WOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:105 SE FRONTIER AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:CEDAREDGE
Mailing Address - State:CO
Mailing Address - Zip Code:81413-4020
Mailing Address - Country:US
Mailing Address - Phone:970-856-7700
Mailing Address - Fax:970-856-7927
Practice Address - Street 1:105 SE FRONTIER AVE
Practice Address - Street 2:SUITE C
Practice Address - City:CEDAREDGE
Practice Address - State:CO
Practice Address - Zip Code:81413-4020
Practice Address - Country:US
Practice Address - Phone:970-856-7700
Practice Address - Fax:970-856-7927
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO4935111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO467438Medicare PIN