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General NPI Number Information
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NPI Number | 1649288689
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Entity Type | Organization
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Legal Business Name | GOBLE HEAL CHIROPRACTIC PC
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 116 E PEARL STREET
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City | WINAMAC
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State | IN
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Zip | 46996
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Country | US
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Telephone | 574-946-4113
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Fax | 574-946-4552
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Provider Business Mailing Address
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Address Line | PO BOX 250 116 E PEARL STREET
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City | WINAMAC
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State | IN
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Zip | 46996
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Country | US
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Telephone | 574-946-4113
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Fax | 574-946-4552
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Authorized Official
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Title or Position | CEO
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Name | DR. MARK A HEAL
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Credential | DC
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Telephone | 574-946-4113
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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 | 08000878A
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 08001280A
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License Number State |
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