Individual
MARK E. GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1709 N WALNUT ST, HARTFORD CITY, IN 47348-1359
(765) 348-4197
Mailing address
103 CONIFER CT, MARION, IN 46953-9195
(765) 664-9014
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003535A
IN
2255A2300X
Athletic Trainer
36000428A
IN
Other
Enumeration date
11/21/2006
Last updated
11/06/2008
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