Individual
MATHEW GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2827 FORT MISSOULA RD, MISSOULA, MT 59804-7408
(406) 327-4171
Mailing address
950 MOUNT AVE APT 202, MISSOULA, MT 59801-5662
(406) 702-9386
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
26233
MT
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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