Provider Demographics
NPI:1649565763
Name:MEGAN GOSS D C LLC
Entity Type:Organization
Organization Name:MEGAN GOSS D C LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-667-6986
Mailing Address - Street 1:37 SAINT ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-4946
Mailing Address - Country:US
Mailing Address - Phone:636-583-0700
Mailing Address - Fax:636-583-0799
Practice Address - Street 1:37 SAINT ANDREWS DR
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-4946
Practice Address - Country:US
Practice Address - Phone:636-583-0700
Practice Address - Fax:636-583-0799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011012773111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty