Individual
CARRESHA GOODLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
W8007 SOUTH US 141/2, #334, IRON, MI 49801-9466
(731) 444-2577
Mailing address
PO BOX 6561, MILWAUKEE, WI 53206-0561
(731) 444-2577
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
2701437960
MI
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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