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Individual

DR. HARRIS IRA GOLDBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1696 SE HILLMOOR DR, STE C, PORT SAINT LUCIE, FL 34952-7699
(772) 335-3222
(772) 335-3793
Mailing address
1696 SE HILLMOOR DR, SUITE C, PORT ST LUCIE, FL 34952-7699
(772) 335-3222
(772) 335-3793

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH005283
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
381-223500
FL
Enumeration date
10/17/2005
Last updated
06/04/2018
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