Individual
JONATHAN GOODRUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1818 52ND ST S, FARGO, ND 58103-7748
(701) 715-5430
Mailing address
901 9TH AVE S, MOORHEAD, MN 56560-3525
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
ND
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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