Individual
SAMANTHA GOODROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6707 FOREST PARK DR, SAVANNAH, GA 31406-2566
(912) 335-1699
Mailing address
2251 E 62ND ST, SAVANNAH, GA 31404-5609
(229) 947-5693
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN084689
GA
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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