Individual
LAURA YASUKO GOODWELL-VELEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5719 WIDEWATERS PKWY, SYRACUSE, NY 13214-1985
(315) 883-5886
Mailing address
2621 GLENROSE AVE, ALTADENA, CA 91001-5031
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003202-1
NY
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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