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Individual

MATTHEW SCOTT GOODRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C

Contact information

Practice address
1296 S SHASTA AVE, EAGLE POINT, OR 97524-8521
(541) 830-4325
(541) 826-2620
Mailing address
171 CANDICE CIR, MEDFORD, OR 97504-9609
(412) 651-3022
(541) 826-2620

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038012175
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500696480
OR
Enumeration date
05/01/2012
Last updated
12/06/2016
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