Individual
JEREMY BENJAMIN GOFORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2815 BONNIE LN, STOCKTON, CA 95204-4411
(925) 381-1187
Mailing address
2815 BONNIE LN, STOCKTON, CA 95204-4411
(925) 381-1187
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
CA
Other
Enumeration date
07/18/2017
Last updated
07/18/2017
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