MEDICARE: DR. TUCKER LEE WOODS D.C.

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	111N00000X	Chiropractor	10829	TX

General Provider Information

NPI Number	:	1881862167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TUCKER LEE WOODS D.C.

Provider Business Mailing Address
First Line	:	213 W MAIN ST
Second Line	:
City	:	HALLSVILLE
State	:	TX
Zip	:	75650-5227
Country	:	US
Telephone Number	:	903-668-2787
Fax Number	:	903-660-2692

Provider Business Practice Location Address
First Line	:	213 W MAIN ST
Second Line	:
City	:	HALLSVILLE
State	:	TX
Zip	:	75650-5227
Country	:	US
Telephone Number	:	903-668-2787
Fax Number	:	903-660-2692

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2008
Last Update Date	:	02/20/2008

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