Individual
DAERICCA JANAE GODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4295 5TH AVE, MARIANNA, FL 32446-2176
(850) 482-8091
Mailing address
2640 MASHBURN RD, MARIANNA, FL 32448-5486
(850) 272-4520
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
31859
FL
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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