Individual
MS. AUDREY MAVIS GOODBAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
2352 PARNELL AVE, LOS ANGELES, CA 90064-2202
(310) 995-0036
Mailing address
PO BOX 7350, BEVERLY HILLS, CA 90212-7350
(310) 995-0036
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
29412
CA
225700000X
Massage Therapist
Primary
29412
CA
Other
Enumeration date
12/15/2011
Last updated
01/30/2012
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