Individual
DR. ELIZABETH ANN GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1529 W ROGERS BLVD STE C, STE C, SKIATOOK, OK 74070-1086
(918) 396-4433
(918) 396-0075
Mailing address
1529 W. ROGERS BLVD., STE C, SKIATOOK, OK 74070-1086
(918) 341-6535
(918) 341-6566
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4086
OK
111N00000X
Chiropractor
CH 9833
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
313002ZPZP
INDIVIDUAL PTAN
OK
01
—
421306
GROUP PTAN
OK
Enumeration date
11/16/2009
Last updated
09/22/2016
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