Individual
DR. JERRY WILLIS GOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1498 SANS SOUCI PKWY, HANOVER TOWNSHIP, PA 18706-6026
(570) 829-5888
(570) 970-2757
Mailing address
1498 SANS SOUCI PKWY, HANOVER TOWNSHIP, PA 18706-6026
(570) 829-5888
(570) 970-2757
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
DC-5357 L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014723000002
—
PA
01
—
5566734
AETNA
—
01
—
800211
BLUE CROSS
—
01
—
G0127263
FIRST PRIORITY
—
01
—
G01678207
HIGHMARK
—
Enumeration date
09/26/2007
Last updated
09/27/2007
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