Organization
GOODLIFE PHYSICAL MEDICINE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVE CARRY DC (MANAGER)
(310) 543-7779
Entity
Organization
Contact information
Practice address
2218 E MAPLE AVE, EL SEGUNDO, CA 90245-6507
(310) 648-7290
Mailing address
2218 E MAPLE AVE, EL SEGUNDO, CA 90245-6507
(310) 648-7290
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
05/10/2016
Last updated
06/09/2017
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