Individual
DR. MARK A WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
506 E BROAD ST, RAYMOND, IL 62560-5202
(217) 573-2400
Mailing address
506 E BROAD ST, RAYMOND, IL 62560-5202
(217) 573-2400
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038004895
IL
111NX0800X
Orthopedic Chiropractor
Primary
038004895
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
974600327
—
IL
Enumeration date
09/28/2006
Last updated
08/17/2018
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