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Organization

GGSKINLASERHAIR LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY GOODMAN NP (NURSE PRACTIONER / OWNER)
(202) 684-7167
Entity
Organization

Contact information

Practice address
4701 SANGAMORE RD STE S207, BETHESDA, MD 20816-2529
(202) 684-7167
(240) 483-0441
Mailing address
4701 SANGAMORE RD STE S207, BETHESDA, MD 20816-2529
(202) 684-7167

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
10/21/2020
Last updated
02/10/2021
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