Individual
DR. GREG THOMAS GOODALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
204 W. 2ND ST, SCHALLER, IA 51053-0369
(712) 275-4790
(712) 275-4349
Mailing address
204 W 2ND ST., PO BOX 369, SCHALLER, IA 51053-0369
(712) 275-4790
(712) 275-4349
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
007292
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IA19158
—
IA
01
—
IB1758
MEDICARE PTAN
—
Enumeration date
04/08/2010
Last updated
04/19/2013
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