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General NPI Number Information
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NPI Number | 1730707928
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Entity Type | Individual
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Provider Name | DARA GREEN GOODSON DPT
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Gender | Female
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 1302 OLD COX RD
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City | ASHEBORO
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State | NC
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Zip | 27205-9466
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Country | US
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Telephone | 336-629-7811
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Fax |
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Provider Business Mailing Address
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Address Line | 3660 MCCONNELL RD APT 2H
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City | GREENSBORO
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State | NC
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Zip | 27405-9780
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Country | US
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Telephone | 704-770-7081
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P19541
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License Number State | NC
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