Individual
GEORGIA GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
74 SMITH RD, HERMON, ME 04401-0725
(207) 469-8704
Mailing address
74 SMITH RD, HERMON, ME 04401-0725
(207) 469-8704
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PA2813
ME
Other
Enumeration date
10/23/2006
Last updated
08/08/2013
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