Provider Demographics
NPI:1396598736
Name:WOODROW, ELI CHARLES
Entity type:Individual
Prefix:
First Name:ELI
Middle Name:CHARLES
Last Name:WOODROW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305 ROCKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BLUE ROCK
Mailing Address - State:OH
Mailing Address - Zip Code:43720-9561
Mailing Address - Country:US
Mailing Address - Phone:740-562-7170
Mailing Address - Fax:
Practice Address - Street 1:6305 ROCKVILLE RD
Practice Address - Street 2:
Practice Address - City:BLUE ROCK
Practice Address - State:OH
Practice Address - Zip Code:43720-9561
Practice Address - Country:US
Practice Address - Phone:740-562-7170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH395867171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications