Individual
MIRANDA GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
HM SMITH BLVD, CAMP LEJEUNE, NC 28540
(910) 451-5125
Mailing address
809 BARN ST, JACKSONVILLE, NC 28540-6708
(217) 721-1422
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
NC
Other
Enumeration date
09/01/2022
Last updated
07/16/2025
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