Individual
DR. JENNIFER LYNN GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
6701 ROCKSIDE RD, SUITE 340, INDEPENDENCE, OH 44131-2358
(216) 520-0033
(216) 707-3729
Mailing address
6701 ROCKSIDE RD, SUITE 340, INDEPENDENCE, OH 44131-2358
(216) 520-0033
(216) 707-3729
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36003353
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2590398
—
OH
Enumeration date
11/10/2005
Last updated
12/19/2012
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