Individual
ELIZABETH D GODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05010407A
IN
225100000X
Physical Therapist
Primary
070018999
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100257920
GROUP MEDICAID
IN
01
—
156546
GROUP MEDICARE
IN
05
—
201004360A
—
IN
Enumeration date
06/08/2010
Last updated
11/09/2016
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