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General NPI Number Information
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NPI Number | 1437783875
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Entity Type | Organization
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Legal Business Name | GOLDEN CENTER FOR HEALTH & HEALING, LLC
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 319 18TH ST
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City | ROCK ISLAND
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State | IL
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Zip | 61201-8715
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Country | US
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Telephone | 309-781-0805
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Fax | 309-429-6471
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Provider Business Mailing Address
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Address Line | 2445 31ST AVENUE CT
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City | MOLINE
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State | IL
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Zip | 61265-6941
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Country | US
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Telephone | 309-781-0805
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Fax | 309-429-6471
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN W. GOLDEN
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Credential | MD
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Telephone | 309-781-0805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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