Individual
LUKE GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
625 SW RAMSEY AVE, STE. B, GRANTS PASS, OR 97527-5808
(541) 479-6979
(541) 479-0204
Mailing address
625 SW RAMSEY AVE, STE. B, GRANTS PASS, OR 97527-5808
(541) 479-6979
(541) 479-0204
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09216
OR
Other
Enumeration date
08/06/2015
Last updated
08/06/2015
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