Provider Demographics
NPI:1083770721
Name:PATRICK L. GOLDSWORTHY, D.C., P.C.
Entity Type:Organization
Organization Name:PATRICK L. GOLDSWORTHY, D.C., P.C.
Other - Org Name:BLUE SPRINGS CHIROPRACTIC HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GOLDSWORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-229-1941
Mailing Address - Street 1:1127 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-3611
Mailing Address - Country:US
Mailing Address - Phone:816-229-1941
Mailing Address - Fax:816-229-7085
Practice Address - Street 1:1127 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-3611
Practice Address - Country:US
Practice Address - Phone:816-229-1941
Practice Address - Fax:816-229-7085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO003834111N00000X
MO006622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO7081050OtherAETNA PROVIDER NUMBER
MO02167019OtherBCBS GROUP NUMBER
MO26419029OtherBCBS PROVIDER NUMBER
MO11362010OtherBCBS PROVIDER NUMBER
MO26419029OtherBCBS PROVIDER NUMBER
MO26419029OtherBCBS PROVIDER NUMBER