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General NPI Number Information
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NPI Number | 1306850995
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Entity Type | Individual
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Provider Name | ROBERT WOODRUFF D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 12/23/2010
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Provider Practice Location Address
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Address Line | 352 MAIN ST NE
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City | LOS LUNAS
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State | NM
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Zip | 87031-7465
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Country | US
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Telephone | 505-865-3333
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Fax | 505-865-3840
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Provider Business Mailing Address
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Address Line | 2622 SAN MATEO BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-3130
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Country | US
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Telephone | 505-888-0331
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Fax | 505-888-1414
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1501
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License Number State | NM
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