Individual
JACEY E GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
491 US ROUTE 1, FREEPORT, ME 04032-7021
(207) 865-6655
(207) 865-6653
Mailing address
491 US ROUTE 1, FREEPORT, ME 04032-7021
(207) 865-6655
(207) 865-6653
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
1766
ME
207Q00000X
Family Medicine Physician
1766
ME
Other
Enumeration date
05/26/2006
Last updated
05/03/2016
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