Organization
GOODWIN CHILDRENS CLINIC, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KATHERYN GOODWIN MSN, APN (NURSE PRACTITIONER/OWNER)
(731) 798-0868
Entity
Organization
Contact information
Practice address
9486 HIGHWAY 412 W, LEXINGTON, TN 38351-5713
(731) 798-0868
Mailing address
PO BOX 185, LEXINGTON, TN 38351-0185
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
13401
TN
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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