Provider Demographics
NPI:1285340349
Name:WOODLAND CHIROS LLC
Entity type:Organization
Organization Name:WOODLAND CHIROS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GOLDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-721-2004
Mailing Address - Street 1:1100 MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3514
Mailing Address - Country:US
Mailing Address - Phone:702-721-2204
Mailing Address - Fax:530-666-5577
Practice Address - Street 1:1100 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3514
Practice Address - Country:US
Practice Address - Phone:702-721-2204
Practice Address - Fax:530-666-5577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty