Individual
MRS. SHELLEY DANIELLE GOEDDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT PHYSICAL THERAPIS
Contact information
Practice address
8747 BIG BEN BLVD, ST LOUIS, MO 63119
(314) 843-0046
Mailing address
22 GRANTWOOD LANE, ST LOUIS, MO 63123-2014
(314) 843-0046
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01282
MO
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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