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Individual

HAROLD JOHN GOEBEL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
4309 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6819
(260) 436-3783
(260) 432-2330
Mailing address
4309 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6819
(260) 436-3783
(260) 432-2330

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001017A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000087061
BLUE CROSS AND BLUE SHIEL
IN
01
4351502
AETNA INS. NUMBER
IN
Enumeration date
04/14/2006
Last updated
07/08/2007
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