Individual
TANNER JAMES GOODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1901 HOWELL AVE, WORLAND, WY 82401-3733
(307) 347-4285
(307) 347-2154
Mailing address
222 S HIGHLAND ST, DU BOIS, PA 15801-2077
(814) 771-5619
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE011221
PA
Other
Enumeration date
06/07/2017
Last updated
06/07/2017
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