Provider Demographics
NPI:1528280609
Name:WOODY, TAJUAN M (DC)
Entity type:Individual
Prefix:DR
First Name:TAJUAN
Middle Name:M
Last Name:WOODY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:972 MONTCLAIR RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1204
Mailing Address - Country:US
Mailing Address - Phone:205-957-5445
Mailing Address - Fax:205-957-5501
Practice Address - Street 1:972 MONTCLAIR RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1204
Practice Address - Country:US
Practice Address - Phone:205-957-5445
Practice Address - Fax:205-957-5501
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2053111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1528280609OtherINDIVIDUAL
AL1528280609OtherINDIVIDUAL