MEDICARE: MS. DONNA BOWIE GOODWIN 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	CHIR008274	GA

General Provider Information

NPI Number	:	1922296193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DONNA BOWIE GOODWIN D.C.

Provider Business Mailing Address
First Line	:	13980 SUNFISH BND
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-0605
Country	:	US
Telephone Number	:	770-346-9036
Fax Number	:	770-346-9036

Provider Business Practice Location Address
First Line	:	8610 ROSWELL RD
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30350-7534
Country	:	US
Telephone Number	:	678-822-0221
Fax Number	:

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

Provider Enumeration Date	:	10/12/2007
Last Update Date	:	10/12/2007

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