Individual
LARRY KENNETH GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2100 LAKE SHORE LANE, MANSFIELD, AR 72944
(479) 462-7891
Mailing address
2100 LAKE SHORE LANE, P.O. BOX 692, MANSFIELD, AR 72944
(479) 462-7891
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1035
AR
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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