Individual
ELLEN GOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
505 ELM ST NE, ALBUQUERQUE, NM 87102-2500
(505) 727-4781
Mailing address
1220 STANFORD DR NE, ALBUQUERQUE, NM 87106-3723
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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