Individual
MS. LARA GOODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
297 LAKE HAVASU AVE S STE 102, LAKE HAVASU CITY, AZ 86403-6526
(928) 453-0501
(928) 453-0502
Mailing address
297 LAKE HAVASU AVE S STE 102, LAKE HAVASU CITY, AZ 86403-6526
(928) 453-0501
(928) 453-0502
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9926A
AZ
Other
Enumeration date
02/11/2013
Last updated
02/11/2013
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