Individual
JONATHAN P GODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMBT
Contact information
Practice address
4104 CROSS CREEK CT APT D, RALEIGH, NC 27607-6549
(252) 399-9809
Mailing address
4104 CROSS CREEK CT APT D, RALEIGH, NC 27607-6549
(252) 399-9809
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13580
NC
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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