Healthcare Provider Details

I. General information

NPI: 1316084023
Provider Name (Legal Business Name): WOOD FAMILY CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N CHESTNUT ST SUITE 108
LA CRESCENT MN
55947-1280
US

IV. Provider business mailing address

205 N CHESTNUT ST SUITE 108
LA CRESCENT MN
55947-1280
US

V. Phone/Fax

Practice location:
  • Phone: 507-895-2225
  • Fax: 507-895-7508
Mailing address:
  • Phone: 507-895-2225
  • Fax: 507-895-7508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3775-12
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4673
License Number StateMN

VIII. Authorized Official

Name: DR. CHRISTOPHER DAVID WOOD
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 507-895-2225