Individual
AMY GOODPASTURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
72 LOYOLA DR, ORMOND BEACH, FL 32176-7805
(386) 852-6590
Mailing address
72 LOYOLA DR, ORMOND BEACH, FL 32176-7805
(386) 852-6590
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
05/10/2016
Last updated
05/10/2016
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