Individual
DAVID R GOODSPEED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C. PED.
Contact information
Practice address
106 ALLEN ST, RUTLAND, VT 05701-4542
(802) 773-1543
Mailing address
106 ALLEN ST, RUTLAND, VT 05701-4542
(802) 773-1543
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
20215273
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006112
—
VT
01
—
1016140001
NGS SUPPLIER
VT
Enumeration date
11/10/2008
Last updated
03/17/2023
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