Individual
MARK GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1477 NORTH 2000 WEST, WESTSIDE MEDICAL, CLINTON, UT 84015
(801) 774-8888
(801) 825-8519
Mailing address
1477 NORTH 2000 WEST, WESTSIDE MEDICAL, CLINTON, UT 84015
(801) 774-8888
(801) 825-8519
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2729721206
UT
Other
Enumeration date
09/15/2006
Last updated
10/13/2009
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