Healthcare Provider Details

I. General information

NPI: 1477799625
Provider Name (Legal Business Name): DR. SEAN T. WOODS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2008
Last Update Date: 01/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 N PITT ST SUITE 100
ALEXANDRIA VA
22314-5600
US

IV. Provider business mailing address

1240 N PITT ST SUITE 100
ALEXANDRIA VA
22314-5600
US

V. Phone/Fax

Practice location:
  • Phone: 703-739-0456
  • Fax:
Mailing address:
  • Phone: 703-739-0456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number0104001826
License Number StateVA

VIII. Authorized Official

Name: DR. SEAN T. WOODS
Title or Position: OWNER
Credential: D.C.
Phone: 703-739-0456