CHIROPRACTIC WELLNESS CENTER OF GOSHEN, PC (NPI# 1174611792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174611792 |
| Entity Type | Organization |
| Organization Name | CHIROPRACTIC WELLNESS CENTER OF GOSHEN, PC |
| Practice Address |
401 E Madison St Goshen IN 46526-3431 |
| Practice Telephone | 5745337363 |
| Mailing Telephone | 5745337363 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MAXIM I IVANOV (OWNER) |
| Authorized Official Telephone | 5745337363 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | CHIROPRACTIC WELLNESS CENTER OF GOSHEN, PC | 1609 Elkhart Road, Goshen, IN 46526 |
| Street Address |
401 E MADISON ST |
| City | GOSHEN |
| State | IN |
| Zip Code | 46526-3431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669560280 | Maxim I Ivanov | Chiropractor | 401 E Madison St, Goshen, IN 46526-3431 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134631344 | Heidi Kauffmann | Social Worker | 2606 Peddler's Village Rd. Suite 210, Goshen, IN 46526 | 2017-10-27 |
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1578086534 | Anthony Escotto | Physical Therapist | 223 North Chicago Avenue, Goshen, IN 46526 | 2017-07-21 |
| 1831544774 | April Noelle Hart | Registered Nurse | 2606 Peddlers Village Rd., Suite 215, Goshen, IN 46526 | 2016-04-28 |
| 1639530108 | Amanda Miller | Physical Therapy Assistant | 114 Watertower Court, Goshen, IN 46526 | 2016-03-11 |
| 1720486095 | Gloria White | Pharmacist | 4430 Elkhart Road, C/o Walgreens, Goshen, IN 46526 | 2014-12-18 |
| 1184982472 | Dianna Christine Hoover | Occupational Therapist | 1627 Autumn Blaze Lane, Goshen, IN 46526 | 2012-04-24 |
| 1629361357 | Amy Rebecca Pointon | Nurse Practitioner | 1615 Winsted Dr Ste 1, Goshen, IN 46526 | 2011-05-27 |
| 1659670685 | Michiana Eye Center LLC | Optometrist | 1747 Stafford Ct, Goshen, IN 46526 | 2011-03-16 |
| 1467759001 | Natasha Candace Pontius | Occupational Therapy Assistant | 2400 College Aveune, Goshen, IN 46526 | 2011-02-17 |
| Find all providers in zip 46526 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679085625 | Avad Chiropractic & Wellness LLC | Chiropractor | 2856 Eisenhower Dr N Ste 1, Goshen, IN 46526-8809 | 2017-10-31 |
| 1932590429 | Homestead Chiropractic | Chiropractor | 50 N Church St, Goshen, NY 10924-1563 | 2015-02-05 |
| 1639414642 | Megan Lynn Keim | Chiropractor | 2424 Peddlers Village Rd, Goshen, IN 46528-5778 | 2012-12-02 |
| 1437493947 | Gerald Rogo | Chiropractor | 66 Prospect Ave, Goshen, NY 10924-8939 | 2012-11-21 |
| 1528369550 | Randall Lee Martin | Chiropractor | 2400 Elkhart Rd, Goshen, IN 46526-1010 | 2010-11-08 |
| 1770806432 | Diego A Marmanillo | Chiropractor | 15 Matthews St Ste 302, Goshen, NY 10924-1995 | 2010-03-10 |
| 1770602203 | New York Chiropractic Healthcare Pllc | Chiropractor | 9 Coates Dr, Goshen, NY 10924-6762 | 2007-03-28 |
| 1639245434 | Virginia Anne Petzold | Chiropractor | 50 North Church Street, Homestead Chiropractic, Goshen, NY 10924 | 2006-11-27 |
| 1295812972 | Elaine K. Bigler-schmeltz | Chiropractor | 210 W Washington St, Goshen, IN 46526-3731 | 2006-11-01 |
| 1760567705 | Stanley Wojnicki | Chiropractor | 252 Greenwich Ave, Goshen, NY 10924-2015 | 2006-10-26 |
| Find all providers in GOSHEN | ||||
Please comment or provide details below to improve the information on CHIROPRACTIC WELLNESS CENTER OF GOSHEN, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.