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General NPI Number Information
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NPI Number | 1871886481
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Entity Type | Organization
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Legal Business Name | WOOD-SCHADE CHIROPRACTIC INC.
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Dates
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Enumeration Date | 05/16/2011
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Last Update Date | 05/16/2011
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Provider Practice Location Address
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Address Line | 11 MAREBLU STE. 160
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3066
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Country | US
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Telephone | 949-643-1500
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Fax | 949-643-1671
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Provider Business Mailing Address
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Address Line | 11 MAREBLU STE. 160
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3066
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Country | US
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Telephone | 949-643-1500
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Fax | 949-643-1671
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. DEBORAH MARIE WOOD-SCHADE
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Credential | D.C., C.C.S.P.
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Telephone | 949-643-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 20043
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License Number State | CA
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