Doctor Name: | DR. TIMOTHY GOULART |
NPI Number: | 1518017078 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C., C.V.C.P. |
License Number: | 272267 |
Business Practice Address: | 424 Ne Franklin Ave Bend, OR - 977014919 |
Business Phone Number: | 5413883588 |
Business Fax Number: | 5413880839 |
Mailing Address: | 424 Ne Franklin Ave, BEND |
State: | OR |
Postal Code: | 977014919 |
Phone Number: | 5413883588 |
Fax Number: | 5413880839 |
NPI Enumeration Date: | 01/10/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 272267 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |