Individual
MR. PHILLIP ARTHUR GOEDECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2851 CENTRE AVE, STE 4, READING, PA 19605-2567
(610) 929-1115
(610) 929-3548
Mailing address
2851 CENTRE AVE, READING, PA 19605-2567
(610) 929-1115
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC003941L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01963101
BLUE CROSS
—
01
—
1031982
ASHN
—
01
—
BE1606382
BLUE SHIELD
—
Enumeration date
10/31/2005
Last updated
10/20/2011
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