MEDICARE: STEPHANIE BRADSHAW WOODRUFF DC

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	2996	SC

General Provider Information

NPI Number	:	1811903818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE BRADSHAW WOODRUFF DC

Provider Business Mailing Address
First Line	:	1019 PHYSICIANS DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5746
Country	:	US
Telephone Number	:	843-571-5366
Fax Number	:	843-571-5659

Provider Business Practice Location Address
First Line	:	1019 PHYSICIANS DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5746
Country	:	US
Telephone Number	:	843-571-5366
Fax Number	:	843-571-5659

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	02/20/2010

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