Individual
CODY DOMENICK GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
227 S MAIN ST, MANCHESTER, NH 03102-4838
(603) 666-8521
Mailing address
227 S MAIN ST, MANCHESTER, NH 03102-4838
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PT5932
NH
Other
Enumeration date
07/05/2009
Last updated
07/05/2009
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