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Individual

DR. ROBERT GRANT GOODWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
4130 LINDEN AVE STE 125, DAYTON, OH 45432-3073
(937) 221-9387
(937) 660-4066
Mailing address
4130 LINDEN AVE STE 125, DAYTON, OH 45432-3073
(937) 221-9387
(937) 660-4066

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1982
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0994081
OH
01
311725337027
CARESOURCE
Enumeration date
02/07/2006
Last updated
05/07/2024
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