Individual
GREGGORY GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
508 14TH AVENUE CT, HAMPTON, IL 61256-9603
(309) 373-4151
Mailing address
508 14TH AVENUE CT, HAMPTON, IL 61256-9603
(309) 373-4151
Taxonomy
Speciality
Code
Description
License number
State
174V00000X
Clinical Ethicist
Primary
160.007718
IL
Other
Enumeration date
11/11/2016
Last updated
11/11/2016
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