Individual
MISS ASIA DENISE GODFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2250 HICKORY RD STE 240, PLYMOUTH MEETING, PA 19462-2225
(334) 497-2671
Mailing address
737 RYEFIELD RD, MONTGOMERY, AL 36117-6988
(334) 497-2671
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-057834
AL
Other
Enumeration date
09/08/2011
Last updated
09/08/2011
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