# HEALTHY AGING CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104171206
- **Authorized official:** MR. EUGENE E. GODFREY D.O. (PHYSICIAN)
- **Authorized official phone:** (302) 422-5700

## Contact information

- **Practice address:** 1014 NORTH WALNUT STREET, MILFORD, DE 19963-1244
- **Practice address phone:** (302) 422-5700
- **Practice address fax:** (302) 424-8018
- **Mailing address:** 1014 NORTH WALNUT STREET, MILFORD, DE 19963-1244
- **Mailing address phone:** (302) 422-5700
- **Mailing address fax:** (302) 424-8018

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/16/2012
- **Last updated:** 07/16/2012