Provider Demographics
NPI:1356398960
Name:GOYETTE, KERRY ANN (DC)
Entity type:Individual
Prefix:DR
First Name:KERRY
Middle Name:ANN
Last Name:GOYETTE
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 1:186 BURRILL ST
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-1835
Mailing Address - Country:US
Mailing Address - Phone:781-593-2388
Mailing Address - Fax:
Practice Address - Street 1:186 BURRILL ST
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-1835
Practice Address - Country:US
Practice Address - Phone:781-593-2388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556360111N00000X
MA2230111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor