Individual
CHAQUIRAH GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 S POINCIANA BLVD, KISSIMMEE, FL 34758-2400
(407) 870-4860
Mailing address
2249 VILLA VERANO WAY APT 303, KISSIMMEE, FL 34744-5970
(954) 798-6651
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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