Individual
JONATHON MATTHEW GODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2400 RUSH ST, LYNCHBURG, SC 29080
(843) 340-7033
Mailing address
2400 RUSH ST, LYNCHBURG, SC 29080-9016
(843) 340-7033
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3372
SC
Other
Enumeration date
10/09/2015
Last updated
10/09/2015
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