Individual
MR. JAKE CLINTON GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
512 19TH ST N, BESSEMER, AL 35020-4821
(205) 424-2020
(205) 425-5665
Mailing address
512 19TH ST N, BESSEMER, AL 35020-4821
(205) 424-2020
(205) 425-5665
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
08007709
AL
Other
Enumeration date
01/16/2008
Last updated
01/16/2008
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