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Organization
CLAY COUNTY PODIATRY, LLC
Active
Organization
CLAY COUNTY PODIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRANDA ANNE GOODALE DPM (MANAGING MEMBER)
(812) 448-9290
Entity
Organization
Contact information
Practice address
955 W CRAIG AVE, BRAZIL, IN 47834-7400
(812) 448-9290
(812) 448-9296
Mailing address
955 W CRAIG AVE, BRAZIL, IN 47834-7400
(812) 448-9290
(812) 448-9296
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07001015A
IN
Other
Enumeration date
07/01/2006
Last updated
05/31/2019
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