Provider Demographics
NPI:1982858510
Name:GOODMAN, JAMES GARET (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GARET
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:GOODMAN
Other - Last Name:GOODMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 2037
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85636-2037
Mailing Address - Country:US
Mailing Address - Phone:928-348-8997
Mailing Address - Fax:928-348-9088
Practice Address - Street 1:247 S 7TH ST
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2535
Practice Address - Country:US
Practice Address - Phone:520-459-1414
Practice Address - Fax:520-459-2077
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor