Individual
KENNETH GOEWEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
2400 GARDEN LAKES BLVD NW, SUITE D, ROME, GA 30165-1100
(706) 232-6600
(706) 232-6677
Mailing address
2400 GARDEN LAKES BLVD NW, SUITE D, ROME, GA 30165-1100
(706) 232-6600
(706) 232-6677
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
000989
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1022740
ACM PROVIDER
GA
01
—
52071299001
BLUE CROSS
GA
Enumeration date
03/21/2006
Last updated
07/09/2007
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