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General NPI Number Information
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NPI Number | 1689950669
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Entity Type | Individual
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Provider Name | MRS. DAWN GOODSON
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Gender | Female
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Dates
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Enumeration Date | 10/22/2011
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Last Update Date | 10/22/2011
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Provider Practice Location Address
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Address Line | 54 SHARP ST
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City | MILLVILLE
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State | NJ
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Zip | 08332-2444
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Country | US
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Telephone | 856-327-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 12 CORNWALL AVE
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City | MILLVILLE
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State | NJ
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Zip | 08332-4847
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 40QB00231300
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License Number State | NJ
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