Individual
JOSEPH GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3641 S SPRING AVE, SAINT LOUIS, MO 63116-4628
(314) 456-9524
Mailing address
3641 S SPRING AVE, SAINT LOUIS, MO 63116-4628
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
154025
MO
Other
Enumeration date
04/20/2009
Last updated
04/20/2009
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