Individual
AMANDA GLYNN GOETHALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
7007 POWERS BOULEVARD, UNIVERSITY PARMA MEDICAL CENTER, PARMA, OH 44129
(440) 743-3006
(440) 743-2131
Mailing address
300 20TH AVE N STE 403, NASHVILLE, TN 37203-5180
(615) 284-4672
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3933
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/15/2017
Last updated
07/15/2020
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