Individual
XIA GOUDEAUX HOWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
103 CANNONBALL LN, NEWARK, DE 19702-3097
(302) 588-4203
Mailing address
103 CANNONBALL LN, NEWARK, DE 19702-3097
(302) 588-4203
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000039216
DE
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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