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Individual

BRUEN C GOOLSBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
13210 US HIGHWAY 87 W, LAVERNIA, TX 78121
(830) 253-7246
Mailing address
PO BOX 675, LA VERNIA, TX 78121-0675
(830) 253-7246

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
9067
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
609669
TX
Enumeration date
06/01/2005
Last updated
01/27/2009
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