Individual
PAYTON GODBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2501
(217) 383-3360
Mailing address
7455 CARPET ROSE DR SE, CALEDONIA, MI 49316-8092
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056016160
IL
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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