Healthcare Provider Details

I. General information

NPI: 1679754667
Provider Name (Legal Business Name): SEAN THOMAS WOODS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2007
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 N PITT ST
ALEXANDRIA VA
22314-5600
US

IV. Provider business mailing address

1240 N PITT ST
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:
Title or Position:
Credential:
Phone: