Individual
BRUCE C GOLDSWORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
941 CENTURY AVE, ANTIGO, WI 54409-2484
(715) 623-7141
Mailing address
601 S 32ND AVE, WAUSAU, WI 54401-3958
(715) 848-2526
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1660-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13056
SECURITY HEALTH PLAN
—
05
—
38884300
—
WI
01
—
CJ7401
RAILROAD MEDICARE GROUP
WI
Enumeration date
09/15/2006
Last updated
12/14/2007
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