Individual
ELICIA GOODALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
171 ASHLEY AVE # MSC908, CHARLESTON, SC 29425-0100
(843) 792-1086
Mailing address
171 ASHLEY AVE # MSC908, CHARLESTON, SC 29425-0100
(843) 792-1086
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
LL84322
SC
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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