Provider Demographics
NPI:1306978366
Name:WOOD CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:WOOD CHIROPRACTIC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHAPPY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-924-8398
Mailing Address - Street 1:150 NELLEN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1197
Mailing Address - Country:US
Mailing Address - Phone:415-924-8398
Mailing Address - Fax:415-927-4720
Practice Address - Street 1:150 NELLEN AVE STE 200
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1197
Practice Address - Country:US
Practice Address - Phone:415-924-8398
Practice Address - Fax:415-927-4720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty