Provider Demographics
NPI:1194537670
Name:TIMOTHY R WOODEAN CHIROPRACTIC AND MASSAGE THERAPY
Entity type:Organization
Organization Name:TIMOTHY R WOODEAN CHIROPRACTIC AND MASSAGE THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WOODEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC LMT
Authorized Official - Phone:716-751-2222
Mailing Address - Street 1:4233 CAMBRIA WILSON RD
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-9797
Mailing Address - Country:US
Mailing Address - Phone:716-243-5136
Mailing Address - Fax:
Practice Address - Street 1:638 LAKE ST STE 3
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NY
Practice Address - Zip Code:14172-9600
Practice Address - Country:US
Practice Address - Phone:716-751-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty