Individual
JARVON D. GODLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
(414) 247-4597
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10884
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36142600
—
WI
Enumeration date
08/30/2007
Last updated
03/24/2008
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