Organization
GOFORTH CHIROPRACTIC LIFE CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FORREST WAYNE GOFORTH D.C. (DR/OWNER/OPERATOR)
(505) 722-9002
Entity
Organization
Contact information
Practice address
108 W HILL AVE, GALLUP, NM 87301-6218
(505) 722-9002
(505) 722-7031
Mailing address
108 W HILL AVE, GALLUP, NM 87301-6218
(505) 722-9002
(505) 722-7031
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
433
NM
Other
Enumeration date
09/25/2007
Last updated
09/25/2007
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