Individual
DR. MALLORY MICHELLE GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
561 CONGRESS ST, PORTLAND, ME 04101-3308
(207) 536-4968
(207) 213-4116
Mailing address
5 CARRIER WOOD RD APT 77, SCARBOROUGH, ME 04074-7192
(207) 205-2294
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5484
ME
Other
Enumeration date
09/16/2019
Last updated
04/25/2024
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