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General NPI Number Information
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NPI Number | 1265888929
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Entity Type | Individual
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Provider Name | NATHANIEL JOEL GOODALL DPT
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Gender | Male
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Dates
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Enumeration Date | 05/11/2016
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Last Update Date | 09/29/2021
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Provider Practice Location Address
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Address Line | 5285 HIGHWAY 280 STE 109
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City | BIRMINGHAM
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State | AL
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Zip | 35242-0317
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Country | US
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Telephone | 205-607-0903
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Fax | 205-607-0904
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Provider Business Mailing Address
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Address Line | PO BOX 306393
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City | NASHVILLE
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State | TN
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Zip | 37230-6393
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Country | US
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Telephone | 615-373-1350
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Fax | 615-373-7116
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11470
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH7977
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License Number State | AL
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