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Mariah Goodell

Physical Therapy Assistant in Surprise, AZ. Individual provider (NPI-1).

NPI number1619708286
StatusActive
Last updated in NPPESAug 13, 2024

Details

NPI
1619708286
Entity type
Individual (NPI-1)
Name
Mariah Goodell
Sex
Female
Sole proprietor
No
Enumeration date
Aug 13, 2024
Certification date
Aug 11, 2024
Last updated
Aug 13, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy AssistantPTA-014534AZYes

Practice location

16350 N Pat Tillman Blvd
Suite 102
Surprise, AZ 85387

Phone 480-863-5201

Mailing address

17816 W Jessie Ln
Surprise, AZ 85387-4056

Phone 720-377-5799

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