Provider Demographics
NPI:1588864342
Name:WOODWARD, TODD C (DC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:C
Last Name:WOODWARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1859 S. TOPAZ WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642
Mailing Address - Country:US
Mailing Address - Phone:208-938-1976
Mailing Address - Fax:208-922-6478
Practice Address - Street 1:1859 S. TOPAZ WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642
Practice Address - Country:US
Practice Address - Phone:208-938-1976
Practice Address - Fax:208-922-6478
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1155111N00000X
IDCHIA-1484111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor