Individual
AMANDA GOODRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3011 S LINDSAY RD STE 105, GILBERT, AZ 85295-4333
(480) 699-5536
Mailing address
3011 S LINDSAY RD STE 105, GILBERT, AZ 85295-4333
(480) 699-5536
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8050
AZ
363AM0700X
Medical Physician Assistant
8050
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
AZ
Other
Enumeration date
04/19/2019
Last updated
10/28/2020
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