Individual
MR. MATTHEW ALAN GODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2515 N CLARK ST STE 802, CHICAGO, IL 60614-2730
(773) 327-3228
(773) 327-1054
Mailing address
2740 N PINE GROVE AVE APT 13C, CHICAGO, IL 60614-6103
(773) 327-3228
(773) 327-1054
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
—
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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