Provider Demographics
NPI:1326810912
Name:GOODWIN, CHLOE ANN (DC)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:ANN
Last Name:GOODWIN
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 1:2360 NORTHWEST 128TH STREET
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323
Mailing Address - Country:US
Mailing Address - Phone:515-398-0730
Mailing Address - Fax:
Practice Address - Street 1:2360 NORTHWEST 128TH STREET
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50323
Practice Address - Country:US
Practice Address - Phone:515-398-0730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA122646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor