Healthcare Provider Details

I. General information

NPI: 1053097188
Provider Name (Legal Business Name): TYLER PATRICK GOZA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 W CENTRAL AVE
WICHITA KS
67212-2840
US

IV. Provider business mailing address

5800 W CENTRAL AVE
WICHITA KS
67212-2840
US

V. Phone/Fax

Practice location:
  • Phone: 316-295-3730
  • Fax: 316-295-3728
Mailing address:
  • Phone: 316-619-1895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number01-06019
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: