Individual
CHRISTA JEANETTE GODDARD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
102B DUNHILL PL NW, CLEVELAND, TN 37311-3883
(423) 559-0444
(423) 559-0103
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446652
—
TN
01
—
3156797
BCBST - GROUP NUMBER
TN
Enumeration date
06/02/2006
Last updated
07/09/2007
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