MEDICARE: DR. DAVID JOSEPH GOECKNER D.C.

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	3432	NC

General Provider Information

NPI Number	:	1538250790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JOSEPH GOECKNER D.C.

Provider Business Mailing Address
First Line	:	2510 CEDAR FOREST WAY APT 103
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-2908
Country	:	US
Telephone Number	:	636-284-0219
Fax Number	:

Provider Business Practice Location Address
First Line	:	6150 FALLS OF NEUSE RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-3528
Country	:	US
Telephone Number	:	919-342-6053
Fax Number	:	919-321-4320

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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