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Individual

WILLIAM L GOODMANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
Mailing address
PO BOX 725, SAINT CLOUD, MN 56302-0725
(320) 258-3090
(320) 258-3095

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R-090336-9
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
087542200
MN
Enumeration date
11/07/2005
Last updated
07/17/2008
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