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Individual

DR. PATRICK ROBERT GOTTFRIED

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
8887 HIGH POINTE DR, SUITE F, NEWBURGH, IN 47630-7969
(812) 490-7386
(812) 490-7386
Mailing address
5844 CYPRESS POINTE DR, NEWBURGH, IN 47630-9843
(812) 480-5835

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038007937
IL
111N00000X
Chiropractor
08002502A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
038007937
IL
01
08021310
BCBS OF IL
IL
01
331358
HEALTHLINK
IL
Enumeration date
08/22/2006
Last updated
04/18/2013
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