Provider Demographics
NPI:1316106693
Name:GOLDBERG CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:GOLDBERG CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-989-6789
Mailing Address - Street 1:3104 E CAMELBACK RD
Mailing Address - Street 2:#816
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4502
Mailing Address - Country:US
Mailing Address - Phone:602-989-6789
Mailing Address - Fax:602-252-0845
Practice Address - Street 1:4045 N 7TH ST
Practice Address - Street 2:SUITE 208
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4736
Practice Address - Country:US
Practice Address - Phone:602-989-6789
Practice Address - Fax:602-252-0845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ883111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty