MEDICARE: WOODS CHIROPRACTIC CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305S00000X	Point of Service	10829	TX

General Provider Information

NPI Number	:	1831360890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODS CHIROPRACTIC CENTER LLC

Provider Business Mailing Address
First Line	:	PO BOX 396
Second Line	:
City	:	HALLSVILLE
State	:	TX
Zip	:	75650-0396
Country	:	US
Telephone Number	:	903-668-2787
Fax Number	:	903-660-2692

Provider Business Practice Location Address
First Line	:	702 WEST MAIN STREET
Second Line	:	SUITE B
City	:	HALLSVILLE
State	:	TX
Zip	:	75650-5227
Country	:	US
Telephone Number	:	903-668-2787
Fax Number	:	903-660-2692

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. TUCKER LEE WOODS
Credential	:	D.C.
Telephone Number	:	903-668-2787

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	09/13/2012

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