Healthcare Provider Details

I. General information

NPI: 1730824640
Provider Name (Legal Business Name): GOULD STANDARD CHIROPRACTIC AND ACUPUNCTURE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 GENESEE ST
UTICA NY
13501-6230
US

IV. Provider business mailing address

2615 GENESEE ST
UTICA NY
13501-6230
US

V. Phone/Fax

Practice location:
  • Phone: 315-404-3868
  • Fax: 315-452-9132
Mailing address:
  • Phone: 315-404-3868
  • Fax: 315-452-9132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DAVID GOULD
Title or Position: OWNER
Credential: DC, LAC
Phone: 315-404-3868