Individual
VICKI GODBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
210 W HARRISON ST, DILLON, SC 29536-3310
(843) 774-7132
(843) 841-2482
Mailing address
1928 GADDYS MILL RD, HAMER, SC 29547-7033
(843) 774-7132
(843) 841-2482
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1200
SC
Other
Enumeration date
04/07/2009
Last updated
04/07/2009
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