Gossett, Tommy Keith

Gossett, Tommy Keith is an sole proprietor health care provider with primary practice located at 2009 Fox Drive , Champaign IL 61820-7364. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Gossett, Tommy Keith can be contacted via phone (217) 351-8040.

Contact Information

Primary practice address
2009 Fox Drive Champaign IL 61820-7364
Fax: (217) 239-5983
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 038003750 Illinois

Profile Details

NPI number 1093760183
LBN Legal business name Gossett, Tommy Keith
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2006
Last updated Jan 12th, 2015 - about 9 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 1093760183 NPPES
Illinois Other 0001082016 BSBC PROVIDER #
Illinois Other 1093760183 BSBC PROVIDER #
Illinois Other 350001628 BSBC PROVIDER #

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