MEDICARE: DR. JAN GOODMAN DC

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	7336	FL

General Provider Information

NPI Number	:	1588872311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAN GOODMAN DC

Provider Business Mailing Address
First Line	:	1911 S FEDERAL HWY
Second Line	:	SUITE 400
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-3331
Country	:	US
Telephone Number	:	561-455-2195
Fax Number	:	561-455-2207

Provider Business Practice Location Address
First Line	:	1911 S FEDERAL HWY
Second Line	:	SUITE 400
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-3331
Country	:	US
Telephone Number	:	561-455-2195
Fax Number	:	561-455-2207

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	11/30/2011

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Directions to “ DR. JAN GOODMAN DC” Practice Location

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