Basic Information
| Provider Information | |||||||||
| NPI: | 1306350095 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LEE A WOOD CHIROPRACTIC INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3336 VENADO ST | ||||||||
| Address2: | |||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920097849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7605189546 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6986 EL CAMINO REAL STE F | ||||||||
| Address2: | |||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920094111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7604389548 | ||||||||
| FaxNumber: | 7604381603 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2017 | ||||||||
| LastUpdateDate: | 11/17/2017 | ||||||||
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| AuthorizedOfficialLastName: | WOOD | ||||||||
| AuthorizedOfficialFirstName: | LEE | ||||||||
| AuthorizedOfficialMiddleName: | ALLEN | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIROPRACTOR/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7605186076 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | 12586 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.