Individual
JAMIE L GOODALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
3133 N MILLBROOK AVE, FRESNO, CA 93703-1425
(559) 453-5798
Mailing address
4681 E WHITE AVE, FRESNO, CA 93702-1642
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
247414
CA
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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