| NPI | 1043407919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORREST WAYNE GOFORTH Dr/Owner/Operator 505-722-9002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NM 433) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2007-09-25 |