Individual
MR. GREGORY LEE GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2153 E JOYCE BLVD, FAYETTEVILLE, AR 72703-4714
(479) 575-9771
Mailing address
2153 E JOYCE BLVD, FAYETTEVILLE, AR 72703-4714
(479) 575-9771
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/16/2011
Last updated
06/16/2011
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