Organization
CHIROPRACTIC WELLNESS CENTER OF GOSHEN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAXIM I IVANOV D.C. (OWNER)
(574) 533-7363
Entity
Organization
Contact information
Practice address
401 E MADISON ST, GOSHEN, IN 46526-3431
(574) 533-7363
Mailing address
401 E MADISON ST, GOSHEN, IN 46526-3431
(574) 533-7363
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
10/10/2006
Last updated
08/22/2020
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