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Individual

MR. JASON GOODIJOHN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
982 N 10TH RD, PALMYRA, NE 68418-4012
(402) 740-1270
Mailing address
982 N 10TH RD, PALMYRA, NE 68418-4012
(402) 740-1270

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
NE
372600000X
Adult Companion
Primary
NE

Other

Enumeration date
02/03/2025
Last updated
02/03/2025
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