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General NPI Number Information
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NPI Number | 1184679615
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Entity Type | Individual
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Provider Name | HARRIET TILLINGHAST GOODRICH PA
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Gender | Female
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 82 HWY 9 NORTH SUITE 2
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City | MILL SPRING
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State | CA
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Zip | 28756
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Country | US
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Telephone | 828-894-2016
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Fax | 828-894-3023
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Provider Business Mailing Address
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Address Line | 40 POSSUM TROT LN
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City | COLUMBUS
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State | NC
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Zip | 28722-9790
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Country | US
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Telephone | 828-301-3318
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 101170
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License Number State | NC
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