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General NPI Number Information
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NPI Number | 1255654448
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Entity Type | Organization
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Legal Business Name | GOHLKE CHIROPRACTIC PC
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Dates
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Enumeration Date | 03/02/2010
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Last Update Date | 01/11/2011
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Provider Practice Location Address
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Address Line | 1119 ROY ST
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City | HOUSTON
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State | TX
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Zip | 77007-3312
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Country | US
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Telephone | 713-876-5092
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Fax |
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Provider Business Mailing Address
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Address Line | 5216 LILLIAN ST
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City | HOUSTON
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State | TX
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Zip | 77007-5227
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Country | US
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Telephone | 713-876-5092
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CECILIA K GOHLKE
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Credential | D.C.
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Telephone | 713-876-5092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 11285
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License Number State | TX
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