Individual
MARIAH GOODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16350 N PAT TILLMAN BLVD, SUITE 102, SURPRISE, AZ 85387
(480) 863-5201
Mailing address
17816 W JESSIE LN, SURPRISE, AZ 85387-4056
(720) 377-5799
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-014534
AZ
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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