Individual
AMY LEE GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2448 W HARVARD AVE, ROSEBURG, OR 97471-2500
(541) 673-2408
(541) 673-2432
Mailing address
7634 N BANK RD, ROSEBURG, OR 97470-8494
(207) 974-6798
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06461
OR
Other
Enumeration date
08/30/2013
Last updated
08/30/2013
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