Provider Demographics
NPI:1053771071
Name:WOODLAND CHIROPRACTIC AND WELLNESS
Entity type:Organization
Organization Name:WOODLAND CHIROPRACTIC AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:NEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-666-5551
Mailing Address - Street 1:3 COURT ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3111
Mailing Address - Country:US
Mailing Address - Phone:530-666-5551
Mailing Address - Fax:530-666-5577
Practice Address - Street 1:3 COURT ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3111
Practice Address - Country:US
Practice Address - Phone:530-666-5551
Practice Address - Fax:530-666-5577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12779111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1053771071OtherUNITED HEALTHCARE
CA1053771071OtherBLUE SHIELD OF CALIFORNIA
CA1053771071OtherANTHEM BLUE CROSS
CA1053771071Medicaid