Individual
WAYNE GOODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 N. WARNER, RIDGECREST, CA 93555
(760) 793-7523
Mailing address
PO BOX 1536, RIDGECREST, CA 93556-1536
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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