Individual
MRS. AUDREY ANN GOFORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
607 NORTH AVE STE 12, WAKEFIELD, MA 01880-1307
(781) 245-5710
Mailing address
123 LILLE RD, NASHUA, NH 03062-2439
(603) 888-0605
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1143
MA
Other
Enumeration date
05/11/2007
Last updated
07/08/2007
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