Individual
MCKENNA BAYLEE GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 JOHN MARSHALL DR HUNTINGTON WV 25755 KH145, HUNTINGTON, WV 25755-0001
(304) 696-7302
Mailing address
67 MAYFAIR WAY, HUNTINGTON, WV 25705-3836
(304) 638-8994
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
IN0010522
WV
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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