Individual
BRANDON THOMAS GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
103 MEDICINE WAY RD, PERIDOT, AZ 85542-5000
(928) 475-1200
Mailing address
418 ENGLISH ELM LN, NORMAN, OK 73069-9629
(405) 694-6597
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6237
OK
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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