Individual
DR. BENJAMIN LEE GOKENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4242 TELEGRAPH RD, SAINT LOUIS, MO 63129-2658
(314) 487-1456
Mailing address
4242 TELEGRAPH RD, SAINT LOUIS, MO 63129-2658
(314) 487-1456
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2018031274
MO
111NR0400X
Rehabilitation Chiropractor
2018031274
MO
111NS0005X
Sports Physician Chiropractor
2018031274
MO
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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