Goforth, Forrest Wayne
Goforth, Forrest Wayne is an sole proprietor health care provider with primary practice located at 108 W Hill Ave , Gallup NM 87301-6218. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Goforth, Forrest Wayne can be contacted via phone (505) 722-9002.Contact Information
Primary practice address
108 W Hill Ave
Gallup NM 87301-6218
Phone: (505) 722-9002
Fax: (505) 722-7031
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 06-00001390 | New Mexico |
Profile Details
| NPI number | 1598833287 |
|---|---|
| LBN Legal business name | Goforth, Forrest Wayne |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 1st, 2006 |
| Last updated | Jun 8th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598833287 | NPPES |
| New Mexico | Other | NMA101797 | MEDICARE ID |
| New Mexico | Other | 608817900 | MEDICARE ID |
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