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Individual

MITCHEL GOODKIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1400 WANTAGH AVENUE, SUITE 103, WANTAGH, NY 11793
(631) 316-1007
Mailing address
1400 WANTAGH AVENUE, SUITE 103, WANTAGH, NY 11793
(631) 316-1007

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X007212
NY

Other

Enumeration date
07/12/2024
Last updated
09/09/2024
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