Goforth Health Center, LLC
Clinic/Center, Health Services in Osage Beach, MO. Organization (NPI-2).
NPI number1114347705
StatusActive
Last updated in NPPESApr 22, 2014
Details
- NPI
- 1114347705
- Entity type
- Organization (NPI-2)
- Legal business name
- Goforth Health Center, LLC
- Organization subpart
- No
- Enumeration date
- Apr 22, 2014
- Last updated
- Apr 22, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QH0100X | Clinic/Center, Health Services | CE0006497 | MO | Yes |
Practice location
4344 Osage Beach PkwyA2
Osage Beach, MO 65065-2175
Phone 573-348-9800
Mailing address
Po Box 2458Lake Ozark, MO 65049-2458
Authorized official
Larry Mark Goforth
Chiropractic Physician
5733489800
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