Provider Demographics
NPI:1023169018
Name:GODSHALL CHIROPRACTIC OFFICES
Entity type:Organization
Organization Name:GODSHALL CHIROPRACTIC OFFICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JONI
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:GODSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:CHIRO AUX PERSONNEL
Authorized Official - Phone:717-872-4636
Mailing Address - Street 1:228 MANOR AVE
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17551-1126
Mailing Address - Country:US
Mailing Address - Phone:717-872-4636
Mailing Address - Fax:717-872-4640
Practice Address - Street 1:228 MANOR AVE
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17551-1126
Practice Address - Country:US
Practice Address - Phone:717-872-4636
Practice Address - Fax:717-872-4640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02425700OtherCAPITAL BLUE CROSS
PA013323OtherHIGHMARK BLUE SHIELD
PA413856OtherHEALTH ASSURANCE
PA0038845000OtherINDEPENDENCE BLUE CROSS
PA0038845000OtherINDEPENDENCE BLUE CROSS