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General NPI Number Information
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NPI Number | 1457547275
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Entity Type | Individual
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Provider Name | HEATHER A FRANK-GOFFE D.C.
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Gender | Female
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Dates
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Enumeration Date | 09/16/2007
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Last Update Date | 09/16/2007
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Provider Practice Location Address
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Address Line | 78 DOUGLAS RD
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City | GLEN RIDGE
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State | NJ
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Zip | 07028-1218
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Country | US
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Telephone | 917-846-6960
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Fax |
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Provider Business Mailing Address
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Address Line | 78 DOUGLAS RD
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City | GLEN RIDGE
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State | NJ
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Zip | 07028-1218
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Country | US
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Telephone | 917-846-6960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 38MC00518100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | X008558-1
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License Number State | NY
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