Individual
GLENN NEAL GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3334 NOYAC ROAD, SAG HARBOR, NY 11963
(631) 725-3398
(631) 725-6302
Mailing address
PO BOX 1448, SAG HARBOR, NY 11963
(631) 725-3398
(631) 725-6302
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X009873
NY
Other
Enumeration date
06/05/2007
Last updated
07/08/2007
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