Provider Demographics
NPI:1508069766
Name:GOEBEL, PATRICK LEE (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:LEE
Last Name:GOEBEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1115 VICKSBURG LN N
Mailing Address - Street 2:SUITE 11
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-3215
Mailing Address - Country:US
Mailing Address - Phone:763-473-7000
Mailing Address - Fax:763-473-7002
Practice Address - Street 1:1115 VICKSBURG LN N
Practice Address - Street 2:SUITE 11
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-3215
Practice Address - Country:US
Practice Address - Phone:763-473-7000
Practice Address - Fax:763-473-7002
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN4932111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor