Individual
HAROLD GOODRUM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
943 MAPLE DR, MORGANTOWN, WV 26505-2812
(304) 599-2515
(304) 285-3738
Mailing address
943 MAPLE DR, MORGANTOWN, WV 26505-2812
(304) 599-2515
(304) 285-3738
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2554
GA
225XH1200X
Hand Occupational Therapist
Primary
2507
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002554
OT LICENSE
GA
Enumeration date
09/19/2016
Last updated
02/04/2025
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