Provider Demographics
NPI:1336261189
Name:GOODMAN, CAZ (DC)
Entity Type:Individual
Prefix:DR
First Name:CAZ
Middle Name:
Last Name:GOODMAN
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 1:720 OLD SNELLVILLE HWY
Mailing Address - Street 2:STE 150
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-6201
Mailing Address - Country:US
Mailing Address - Phone:678-225-5553
Mailing Address - Fax:678-225-5554
Practice Address - Street 1:720 OLD SNELLVILLE HWY
Practice Address - Street 2:STE 150
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-6201
Practice Address - Country:US
Practice Address - Phone:678-225-5553
Practice Address - Fax:678-225-5554
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor