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Individual

DR. TIMOTHY GOODWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
392 E 12300 S STE C, DRAPER, UT 84020-8043
(801) 523-8700
(801) 523-8191
Mailing address
392 E 12300 S STE C, DRAPER, UT 84020-8043
(801) 523-8700
(801) 523-8191

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
3583261202
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3583261202
STATE LICENSE
UT
Enumeration date
11/13/2006
Last updated
07/09/2007
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