Individual
COURTNEY GOODRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11830 W 75TH ST, SHAWNEE, KS 66214-1366
(620) 440-1152
Mailing address
11830 W 75TH ST, SHAWNEE, KS 66214-1366
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-100441
KS
Other
Enumeration date
07/09/2016
Last updated
07/09/2016
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