Individual
MR. LAURANCE GOODWIN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
5719 WIDEWATERS PKWY, SYRACUSE, NY 13214-1985
(315) 883-5886
Mailing address
868 IRISH SETTLEMENT RD, FREEVILLE, NY 13068-5629
(908) 268-4587
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002549
NY
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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