Individual
SAMANTHA GOODMANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5525 141ST ST N, HUGO, MN 55038-8429
(612) 356-8764
Mailing address
12100 SINGLETREE LN STE 196, EDEN PRAIRIE, MN 55344-7961
(612) 746-1341
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
27-0897702
MN
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
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