Provider Demographics
NPI:1821571563
Name:GOEBEL, CHRISTIE (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:GOEBEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 WALNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-9542
Mailing Address - Country:US
Mailing Address - Phone:606-226-3080
Mailing Address - Fax:
Practice Address - Street 1:1795 ALYSHEBA WAY STE 4103
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2488
Practice Address - Country:US
Practice Address - Phone:859-335-0419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5583111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor