Individual
LAUREN E GOATER-MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3 RIVERSIDE CIRCLE, ROANOKE, VA 24016
(540) 224-5170
(540) 985-9612
Mailing address
3 RIVERSIDE CIRCLE, ROANOKE, VA 24016
(540) 224-5170
(540) 985-9612
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001413
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010260558
—
VA
Enumeration date
08/09/2005
Last updated
01/13/2011
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