Individual
MR. JUSTIN BLAKE GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, LDN
Contact information
Practice address
1301 YORK RD STE 800, TIMONIUM, MD 21093-6011
(410) 686-0459
(425) 242-3401
Mailing address
9232 RAVENWOOD RD, ROSEDALE, MD 21237-3425
(443) 803-2381
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
MD
Other
Enumeration date
02/12/2022
Last updated
08/11/2023
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