Provider Demographics
NPI:1659496487
Name:GODBEY CHIROPRACTIC
Entity Type:Organization
Organization Name:GODBEY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GODBEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:251-937-7636
Mailing Address - Street 1:110 MCCONNELL AVE
Mailing Address - Street 2:
Mailing Address - City:BAY MINETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36507-4023
Mailing Address - Country:US
Mailing Address - Phone:251-937-7636
Mailing Address - Fax:251-937-3574
Practice Address - Street 1:110 MCCONNELL AVE
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-4023
Practice Address - Country:US
Practice Address - Phone:251-937-7636
Practice Address - Fax:251-937-3574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1279111N00000X
AL0710111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1376656371OtherNPI
AL1639282536OtherNPI
ALT68421Medicare UPIN
AL051517023Medicare ID - Type Unspecified
AL1376656371OtherNPI
AL1639282536OtherNPI