Provider Demographics
NPI:1578845418
Name:GOODBINDER, JAY M (DC)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:M
Last Name:GOODBINDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9215 W 102ND ST APT C
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5315
Mailing Address - Country:US
Mailing Address - Phone:913-952-3931
Mailing Address - Fax:
Practice Address - Street 1:7337 BROADWAY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114
Practice Address - Country:US
Practice Address - Phone:816-523-4600
Practice Address - Fax:816-523-4724
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011029290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor