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Individual

JENNIFER GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
303 N HURSTBOURNE PKWY, 200, LOUISVILLE, KY 40222-5185
(502) 412-5847
Mailing address
6416 TUPPER LAKE RD, SUNFIELD, MI 48890-9733
(517) 290-5548

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502001974
MI

Other

Enumeration date
08/14/2012
Last updated
08/14/2012
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