Individual
MR. NICHOLAS S WOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASE MANAGER
Contact information
Practice address
413 SIPAPU ROAD, BOX 6952, TAOS, NM 87571
(505) 758-5857
(505) 758-2832
Mailing address
PO BOX 808, ARROYO SECO, NM 87514
(505) 770-0530
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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