Organization
GOFORTH HEALTH CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY MARK GOFORTH D.C. (CHIROPRACTIC PHYSICIAN)
(573) 348-9800
Entity
Organization
Contact information
Practice address
4344 OSAGE BEACH PKWY, A2, OSAGE BEACH, MO 65065-2175
(573) 348-9800
Mailing address
PO BOX 2458, LAKE OZARK, MO 65049-2458
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
CE0006497
MO
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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