Provider Demographics
NPI:1730199373
Name:WOERNER, CARL WILLIAM (DC)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:WILLIAM
Last Name:WOERNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23425 N 39TH DRIVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310
Mailing Address - Country:US
Mailing Address - Phone:623-580-0266
Mailing Address - Fax:623-580-8879
Practice Address - Street 1:23425 N 39TH DRIVE
Practice Address - Street 2:SUITE 103
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310
Practice Address - Country:US
Practice Address - Phone:623-580-0266
Practice Address - Fax:623-580-8879
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ04227111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor