LEDONTRAE GOODEN

FORT MOORE, GA
NPI1528607272
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant, Medical
Additional Taxonomies172A00000X Driver
Enumeration Date2019-12-28
Last Update Date2024-01-22
Business Address
Mr. LEDONTRAE GOODEN PA-C
6600 VAN AALST BLVD
FORT MOORE, GA 31905-2102
Phone number: 916-385-1006
Mailing Address
Mr. LEDONTRAE GOODEN PA-C
6600 VAN AALST BLVD BLDG 9250
FORT MOORE, GA 31905-2102
Phone number: 916-385-1006
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