Provider Demographics
NPI:1568668572
Name:PATRICK A. GOOD, D.C., P.C.
Entity Type:Organization
Organization Name:PATRICK A. GOOD, D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-739-2775
Mailing Address - Street 1:14010 ROUTE 8 89
Mailing Address - Street 2:
Mailing Address - City:WATTSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16442-2922
Mailing Address - Country:US
Mailing Address - Phone:814-739-2775
Mailing Address - Fax:814-739-2606
Practice Address - Street 1:14010 ROUTE 8 89
Practice Address - Street 2:
Practice Address - City:WATTSBURG
Practice Address - State:PA
Practice Address - Zip Code:16442-2922
Practice Address - Country:US
Practice Address - Phone:814-739-2775
Practice Address - Fax:814-739-2606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001443L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006343980002Medicaid
PA303988OtherUPMC
PAT28707Medicare UPIN
PA0006343980002Medicaid