STACEY A GOOD

LEWISTON, ID
NPI1487944336
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: ID  O1065)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: TX  Q7881)
Enumeration Date2011-04-12
Last Update Date2019-02-22
Business Address
STACEY A GOOD D.O.
415 6TH ST
LEWISTON, ID 83501-2431
Phone number: 512-730-3056
Mailing Address
STACEY A GOOD D.O.
7500 RIALTO BLVD STE 1-140
AUSTIN, TX 78735-8534
Phone number: 512-730-3056