Individual
ETOYA GODBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2521 N ELMS RD. FLUSHING,, FLUSHING, MI 48433
(866) 498-9099
Mailing address
2521 N ELMS RD., FLUSHING, MI 48433
(866) 498-3909
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704319273
MI
163WA2000X
Administrator Registered Nurse
4704319273
MI
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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