Individual
MS. REBECCA MARIE GOODRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP, NCTMB
Contact information
Practice address
700 S MAIN ST, GRITMAN MEDICAL CENTER, MOSCOW, ID 83843-3056
(208) 883-6361
(208) 883-6452
Mailing address
PO BOX 3162, MOSCOW, ID 83843-1907
(208) 310-9375
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60098139
WA
Other
Enumeration date
10/15/2009
Last updated
10/15/2009
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