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General NPI Number Information
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NPI Number | 1952329005
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Entity Type | Individual
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Provider Name | WILLIAM JOHN GOLAS DC
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 1404 E NAPIER AVE
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City | BENTON HARBOR
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State | MI
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Zip | 49022-2136
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Country | US
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Telephone | 269-926-8213
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Fax | 269-926-8215
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Provider Business Mailing Address
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Address Line | 64060 66TH AVE
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City | HARTFORD
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State | MI
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Zip | 49057-9692
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Country | US
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Telephone | 269-208-3122
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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 | 2301006669
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License Number State | MI
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