Healthcare Provider Details

I. General information

NPI: 1861604860
Provider Name (Legal Business Name): CHRISTOPHER J WOODROW, D.C., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 E ASHLAND AVE.
MT. ZION IL
62549-1272
US

IV. Provider business mailing address

103 E ASHLAND AVE.
MT. ZION IL
62549-1272
US

V. Phone/Fax

Practice location:
  • Phone: 217-864-5566
  • Fax: 217-864-4497
Mailing address:
  • Phone: 217-864-5566
  • Fax: 217-864-4497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038006572
License Number StateIL

VIII. Authorized Official

Name: DR. CHRISTOPHER JOHN WOODROW
Title or Position: PRESIDENT
Credential: D.C.
Phone: 217-864-5566