Individual
DR. SCOTT THEODOR GODBERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1400 WALDO HALTER MEM DR, NEOSHO, MO 64850-2034
(417) 455-1025
(417) 455-2273
Mailing address
1400 WALDO HALTER MEM DR, PO BOX 355, NEOSHO, MO 64850-2034
(417) 455-1025
(417) 455-2273
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2008015775
MO
111N00000X
Chiropractor
3847
OK
111N00000X
Chiropractor
4833
MN
Other
Enumeration date
08/15/2006
Last updated
04/06/2015
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