Provider Demographics
NPI:1689794562
Name:GOINS, RICKEY LEON (DC,)
Entity Type:Individual
Prefix:DR
First Name:RICKEY
Middle Name:LEON
Last Name:GOINS
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 1:16 BEECH RD SE APT 90
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-3334
Mailing Address - Country:US
Mailing Address - Phone:770-422-3947
Mailing Address - Fax:
Practice Address - Street 1:16 BEECH RD SE APT 90
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30008-3334
Practice Address - Country:US
Practice Address - Phone:770-422-3947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008036111NR0400X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician