Provider Demographics
NPI:1063533628
Name:GOBER CHIROPRACTIC CENTERS INC
Entity type:Organization
Organization Name:GOBER CHIROPRACTIC CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:443-725-4930
Mailing Address - Street 1:5430 CAMPBELL BLVD
Mailing Address - Street 2:STE. 106
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-5500
Mailing Address - Country:US
Mailing Address - Phone:443-725-4930
Mailing Address - Fax:443-725-4933
Practice Address - Street 1:5430 CAMPBELL BLVD
Practice Address - Street 2:STE. 106
Practice Address - City:WHITE MARSH
Practice Address - State:MD
Practice Address - Zip Code:21162-5500
Practice Address - Country:US
Practice Address - Phone:443-725-4930
Practice Address - Fax:443-725-4933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD23ZKOtherCAREFIRST
MD6146OtherCAREFIRST
MD6146OtherCAREFIRST