Individual
MRS. JANN W. GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
844 N. ELLSWORTH, MESA, AZ 85207-5114
(480) 380-2810
(480) 380-2861
Mailing address
7746 E BOSTON ST, MESA, AZ 85207
(480) 380-2810
(480) 380-2861
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5005
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
755308
—
AZ
01
—
AZ0298870
BCBS NUMBER
AZ
Enumeration date
05/23/2006
Last updated
02/20/2012
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