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Individual
MR. JEREMY E GOFTON
Active
Individual
MR. JEREMY E GOFTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RNFA
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
125349
CO
163WR0006X
Registered Nurse First Assistant
Primary
RN139696
AZ
Other
Enumeration date
12/02/2009
Last updated
05/30/2014
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