Provider Demographics
NPI:1528119682
Name:WILLIAM F GOSS DC I PLLC
Entity type:Organization
Organization Name:WILLIAM F GOSS DC I PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:GOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-264-2100
Mailing Address - Street 1:5600 METROPOLITAN PKWY
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4107
Mailing Address - Country:US
Mailing Address - Phone:586-264-2100
Mailing Address - Fax:586-264-1117
Practice Address - Street 1:5600 METROPOLITAN PKWY
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4107
Practice Address - Country:US
Practice Address - Phone:586-264-2100
Practice Address - Fax:586-264-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIG07169OtherBCN GROUP #
MI950E012410OtherBCBS GROUP #
MIG07169OtherBCN GROUP #