Organization
JWG, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANN W. GOODMAN PT (PRESIDENT/OWNER)
(602) 321-1698
Entity
Organization
Contact information
Practice address
844 N. ELLSWORTH, MESA, AZ 85207-5114
(480) 380-2810
(480) 380-2861
Mailing address
844 N. ELLSWORTH, MESA, AZ 85207-5114
(480) 380-2810
(480) 380-2861
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5005
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0298870
BCBS
AZ
Enumeration date
01/31/2007
Last updated
02/20/2012
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