MEDICARE: RON A WOOD D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC22897	CA

General Provider Information

NPI Number	:	1134179468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RON A WOOD D.C.

Provider Business Mailing Address
First Line	:	1901 N GLENOAKS BLVD
Second Line	:	SUITE A
City	:	BURBANK
State	:	CA
Zip	:	91504-3800
Country	:	US
Telephone Number	:	818-557-1337
Fax Number	:	818-557-7635

Provider Business Practice Location Address
First Line	:	1901 N GLENOAKS BLVD
Second Line	:	SUITE A
City	:	BURBANK
State	:	CA
Zip	:	91504-3800
Country	:	US
Telephone Number	:	818-557-1337
Fax Number	:	818-557-7635

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	12/09/2011

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Directions to “ RON A WOOD D.C.” Practice Location

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