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Individual

AMBER GOODLOE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1400 HOWARD RD, MADERA, CA 93637-5125
(559) 661-8380
Mailing address
1400 HOWARD RD, MADERA, CA 93637-5125
(559) 661-8380

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
78447
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1760424592
CA
Enumeration date
08/21/2018
Last updated
08/21/2018
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