Diane Goodman
Physical Therapist in Meridian, ID. Individual provider (NPI-1).
NPI number1124458435
StatusActive
Last updated in NPPESNov 22, 2013
Details
- NPI
- 1124458435
- Entity type
- Individual (NPI-1)
- Name
- Diane Goodman
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 22, 2013
- Last updated
- Nov 22, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | PT-1736 | ID | Yes |
Practice location
520 S Eagle Rd Ste 2106Meridian, ID 83642-6363
Phone 208-706-5775 · Fax 208-706-5777
Mailing address
3732 S Daisy WayBoise, ID 83709-3762
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