JONATHAN HANCOCK GOODMAN

POCATELLO, ID
NPI1093371031
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: ID  PT-6416)
Enumeration Date2019-05-15
Last Update Date2019-05-15
Business Address
JONATHAN HANCOCK GOODMAN DPT
1800 FLANDRO DR STE 190
POCATELLO, ID 83202-4940
Phone number: 208-233-2248
Mailing Address
JONATHAN HANCOCK GOODMAN DPT
1800 FLANDRO DR STE 190
POCATELLO, ID 83202-4940
Phone number: 208-233-2248