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Individual
MONA LEE GOATLEY
Active
Individual
MONA LEE GOATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501002783
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B50737
BLUE CROSS
MI
05
—
1083902449
—
MI
Enumeration date
07/19/2011
Last updated
06/25/2024
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