MEDICARE: WILLIAM F GOSS DC I PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G07169	OTHER	MI	BCN GROUP #
2	950E012410	OTHER	MI	BCBS GROUP #

General Provider Information

NPI Number	:	1528119682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM F GOSS DC I PLLC

Provider Business Mailing Address
First Line	:	5600 METROPOLITAN PKWY
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4107
Country	:	US
Telephone Number	:	586-264-2100
Fax Number	:	586-264-1117

Provider Business Practice Location Address
First Line	:	5600 METROPOLITAN PKWY
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4107
Country	:	US
Telephone Number	:	586-264-2100
Fax Number	:	586-264-1117

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIAM FRANCIS GOSS
Credential	:	DC
Telephone Number	:	586-264-2100

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	10/01/2013

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