Individual
DIANE RENE GODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1970 BOULEVARD, SALEM, VA 24153-6404
(540) 982-2463
(540) 855-3469
Mailing address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
(540) 855-3469
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110001198
VA
Other
Enumeration date
04/26/2006
Last updated
11/29/2011
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