Individual
CYNTHIA GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
219 S LEMACKS ST, WALTERBORO, SC 29488-4374
(843) 549-1516
Mailing address
219 S LEMACKS ST, WALTERBORO, SC 29488-4374
(843) 549-1516
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
29285
SC
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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