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Organization
GARY A. GOERG, DC, PA
Active
Organization
GARY A. GOERG, DC, PA
Active
Other names
Back Pain Institute of Port Charlotte
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY ANTON GOERG D.C. (PRESIDENT)
(941) 235-3535
Entity
Organization
Contact information
Practice address
2496 CARING WAY, UNIT B, PORT CHARLOTTE, FL 33952-5336
(941) 235-3535
(941) 235-3550
Mailing address
2496 CARING WAY, UNIT B, PORT CHARLOTTE, FL 33952-5336
(941) 235-3535
(941) 235-3550
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH7167
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55458Z
PROVIDER NUMBER PER CCN: 920515184914
FL
01
—
K8198
GROUP IDENTIFICATION NUMBER PER CCN:920515184914
FL
01
—
U63581
UPIN PER CCN: 920515184914
FL
Enumeration date
03/17/2009
Last updated
03/17/2009
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