Organization
THREE FOUNTAINS CHIROPRACTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID R GOOLDY DC (PRESIDENT)
(803) 808-1897
Entity
Organization
Contact information
Practice address
1926 S LAKE DR, LEXINGTON, SC 29073-8282
(803) 808-1897
Mailing address
PO BOX 84428, 1926 SOUTH LAKE DRIVE, LEXINGTON, SC 29073-0008
(803) 808-1897
(803) 808-1297
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2108
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CH2108
—
SC
Enumeration date
10/04/2005
Last updated
08/24/2007
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