Individual
MR. J DAVID GOODLAXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
3033 LINCOLN PARK DR, GALESBURG, IL 61401-1127
(309) 344-2814
(309) 344-2814
Mailing address
PO BOX 425, GALESBURG, IL 61402-0425
(309) 344-2814
(309) 344-2814
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051030187
IL
Other
Enumeration date
04/25/2011
Last updated
04/25/2011
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