Individual
JASON EDWARD GOODIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, OTR/L
Contact information
Practice address
500 LAKETOWER DR, UNIT 2, LEXINGTON, KY 40502-2677
(310) 995-9018
Mailing address
500 LAKETOWER DR, UNIT 2, LEXINGTON, KY 40502-2677
(310) 995-9018
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R4119
KY
Other
Enumeration date
05/13/2012
Last updated
05/13/2012
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