Provider Demographics
NPI:1336173665
Name:TIMOTHY G. GOOD, D.C.
Entity Type:Organization
Organization Name:TIMOTHY G. GOOD, D.C.
Other - Org Name:GOOD CHIROPRACTIC CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:GOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-825-4805
Mailing Address - Street 1:3813 DEXTER AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504-2433
Mailing Address - Country:US
Mailing Address - Phone:814-825-4805
Mailing Address - Fax:814-825-3144
Practice Address - Street 1:3813 DEXTER AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16504-2433
Practice Address - Country:US
Practice Address - Phone:814-825-4805
Practice Address - Fax:814-825-3144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-0001954-L261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center