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
Fax: (505) 722-7031
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598833287 NPPES
New Mexico Other NMA101797 MEDICARE ID
New Mexico Other 608817900 MEDICARE ID

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