Individual
DR. LARRY MARK GOFORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3251 BAGNELL DAM BLVD PMB 155, LAKE OZARK, MO 65049-9745
(573) 348-9800
(573) 348-9802
Mailing address
4344 HIGHWAY 54, SUITE 2 A, OSAGE BEACH, MO 65065-2175
(573) 348-9800
(573) 348-9802
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
006497
MO
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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