Individual
DR. HENRY L GOETZ JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1524 HIGHWAY 18W, CLEAR LAKE, IA 50428-1105
(641) 357-7189
(641) 357-7189
Mailing address
1524 HIGHWAY 18 WEST, CLEAR LAKE, IA 50428-1105
(641) 357-7189
(641) 357-7189
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
0060000625
VT
111N00000X
Chiropractor
0104000343
VA
111N00000X
Chiropractor
Primary
02980
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023002
—
IA
01
—
02300
BLUE SHIELD IA WELLMARK
—
Enumeration date
02/17/2006
Last updated
07/08/2007
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