Provider Demographics
NPI:1275001091
Name:GOUKER, ALLISON MARIE (DC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:GOUKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 PRAY BLVD
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43566-8717
Mailing Address - Country:US
Mailing Address - Phone:419-878-8142
Mailing Address - Fax:419-878-8143
Practice Address - Street 1:1222 PRAY BLVD
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43566-8717
Practice Address - Country:US
Practice Address - Phone:419-878-8142
Practice Address - Fax:419-878-8143
Is Sole Proprietor?:No
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-04848111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor