Organization
CRITERION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SALLY A GOODHILE PT (PER DIEM PHYSICAL THERAPIST)
(978) 632-4432
Entity
Organization
Contact information
Practice address
31 LAKE ST, GARDNER, MA 01440-3879
(978) 632-4432
(197) 863-2602
Mailing address
31 LAKE ST, GARDNER, MA 01440-3879
(978) 632-4432
(197) 863-2602
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
5211
MA
Other
Enumeration date
03/06/2014
Last updated
03/06/2014
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