Provider Demographics
NPI:1033372990
Name:SHON JAMES GOULDING DC PC
Entity Type:Organization
Organization Name:SHON JAMES GOULDING DC PC
Other - Org Name:GOULDING CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:GOULDING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-614-0550
Mailing Address - Street 1:880 HERITAGE PARK BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041
Mailing Address - Country:US
Mailing Address - Phone:801-614-0550
Mailing Address - Fax:
Practice Address - Street 1:880 HERITAGE PARK BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041
Practice Address - Country:US
Practice Address - Phone:801-614-0550
Practice Address - Fax:801-614-0554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty