Individual
MARY ANN GOODRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
66 HILL STREET, WOODVILLE, MS 39669
(601) 213-7055
(601) 888-6876
Mailing address
PO BOX 1594, WOODVILLE, MS 39669-1594
(601) 213-7055
(601) 888-6876
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
801901868
MS
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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