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General NPI Number Information
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NPI Number | 1477657948
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Entity Type | Individual
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Provider Name | LEE GOOZDICH D. C.
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Gender | Male
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 10/03/2012
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Provider Practice Location Address
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Address Line | 565 NATIONAL PIKE W
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City | BROWNSVILLE
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State | PA
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Zip | 15417-9221
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Country | US
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Telephone | 724-785-7633
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Fax | 724-785-7632
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Provider Business Mailing Address
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Address Line | 122 SCENIC RIDGE DR
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City | VENETIA
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State | PA
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Zip | 15367-2342
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Country | US
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Telephone | 724-942-3836
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC0035424L
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License Number State | PA
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