Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 62650 | MN |
N | 2081P2900X | Pain Medicine | 01085754A | IN |
NPI | 1396109062 |
---|---|
Provider Name | Charonn D Woods |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2016 |
Last Update Date | 20/10/2021 |