Provider Demographics
NPI:1073679403
Name:WOODS, RONALD G (DC)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:G
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 1:701 NORTHLAKE BLVD
Mailing Address - Street 2:SUITE101
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-5215
Mailing Address - Country:US
Mailing Address - Phone:561-845-7292
Mailing Address - Fax:561-845-9184
Practice Address - Street 1:701 NORTHLAKE BLVD
Practice Address - Street 2:SUITE101
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-5215
Practice Address - Country:US
Practice Address - Phone:561-845-7292
Practice Address - Fax:561-845-9184
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0008979111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT56043Medicare UPIN