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Individual

ROBERT G GOODRICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
830 N MAIN ST, SUITE 1, SPEARFISH, SD 57783-2185
(605) 642-2645
(605) 642-8345
Mailing address
830 N MAIN ST, SUITE 1, SPEARFISH, SD 57783-2185
(605) 642-2645
(605) 642-8345

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
120
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9201180
SD
Enumeration date
05/19/2006
Last updated
10/02/2008
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