Provider Demographics
NPI:1205030509
Name:GOEBEL CHIROPRACTIC AND FAMILY WELLNESS, P.A.
Entity Type:Organization
Organization Name:GOEBEL CHIROPRACTIC AND FAMILY WELLNESS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GOEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-473-7000
Mailing Address - Street 1:1115 VICKSBURG LN N
Mailing Address - Street 2:SUITE 11
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-3215
Mailing Address - Country:US
Mailing Address - Phone:763-473-7000
Mailing Address - Fax:763-473-7002
Practice Address - Street 1:1115 VICKSBURG LN N
Practice Address - Street 2:SUITE 11
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-3215
Practice Address - Country:US
Practice Address - Phone:763-473-7000
Practice Address - Fax:763-473-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4932261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care