Individual
AMY GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 WILLIAMS ST, ADRIAN, MI 49221-2563
(815) 307-0987
Mailing address
3316 CHESTNUT DR, MCHENRY, IL 60051-2691
(815) 307-0987
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
G355-0119-7940
IL
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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