NPI | 1952606659 |
---|---|
Former Name | CRYSTAL M WOODBURY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2011000648) |
Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: MO 2011000648) |
111NP0017X Chiropractor, Pediatric Chiropractor (Licence: MO 2011000648) | |
Enumeration Date | 2011-01-11 |
Last Update Date | 2014-09-12 |