Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1379 | MN |
NPI | 1508909391 |
---|---|
Provider Name | Howard Woolley |
First Address | Winona, MN 55987-1530 |
Second Address | Winona, MN 55987-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 21/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E52710 | (02) | MN |