MEDICARE: CHAD WOODWARD CMT

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	225700000X	Massage Therapist	35283	CA

General Provider Information

NPI Number	:	1831732189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD WOODWARD CMT

Provider Business Mailing Address
First Line	:	1826 S COAST HWY
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-5322
Country	:	US
Telephone Number	:	760-453-5179
Fax Number	:

Provider Business Practice Location Address
First Line	:	1826 S COAST HWY
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-5322
Country	:	US
Telephone Number	:	760-453-5179
Fax Number	:

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

Provider Enumeration Date	:	10/18/2019
Last Update Date	:	10/18/2019

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Directions to “ CHAD WOODWARD CMT” Practice Location

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