Provider Information for 1649713397
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LAUREN GOODLET
Sex: Female
NPI: 1649713397
Last Updated: 2016-11-29
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1649713397 | ||||||||
| Enumeration Date | 2016-11-29 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3204 HOLLYBROOK LN MOGADORE, OH 44260-8617 United States Phone: 419-306-6800 | Fax: | ||||||||
| Primary Practice Address | 900 MULL AVE AKRON, OH 44313-7502 United States Phone: 330-867-5603 | Fax: | ||||||||
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