Individual
DR. BRENDA T GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
10 TRIEBLE DR, TUNKHANNOCK, PA 18657-7054
(570) 996-2700
(570) 996-2711
Mailing address
100 N ACADEMY AVE, CREDENTIALS DEPT, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS008148L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001550962
—
PA
Enumeration date
03/10/2006
Last updated
08/19/2020
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