Individual
KAITLIN A GOFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
404 W FOUNTAIN ST, ALBERT LEA, MN 56007-2437
(507) 360-0000
Mailing address
2187 N CRAILSHEIM DR, WORTHINGTON, MN 56187-1773
(507) 360-0000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
03/08/2016
Last updated
09/28/2020
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