Individual
MRS. LAURA K GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
12081 MASON DR, QUANTICO, VA 22134
(610) 764-0027
Mailing address
12081 MASON DR, QUANTICO, VA 22134-2003
(610) 764-0027
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000007817
PA
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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