Individual
JOHN GOTHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1220 W NORTH ST, MUNCIE, IN 47303-3619
(765) 273-2055
Mailing address
1220 W NORTH ST, MUNCIE, IN 47303-3619
(765) 273-2055
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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