Provider Demographics
NPI:1033496229
Name:GOODWIN, ALLIE DAY (DC, DIPLAC)
Entity Type:Individual
Prefix:DR
First Name:ALLIE
Middle Name:DAY
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:DC, DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12171 W PARMER LN
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7549
Mailing Address - Country:US
Mailing Address - Phone:512-588-1501
Mailing Address - Fax:512-588-1502
Practice Address - Street 1:12171 W PARMER LN
Practice Address - Street 2:SUITE 203
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7549
Practice Address - Country:US
Practice Address - Phone:512-588-1501
Practice Address - Fax:512-588-1502
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11447111N00000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist