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1558520114
KIM DALE GOODRUM
MODESTO, CA
NPI
1558520114
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163WP0808X Registered Nurse, Psych/Mental Health
(Licence: CA 696742)
Enumeration Date
2008-06-08
Last Update Date
2008-06-08
Business Address
Mr. KIM DALE GOODRUM R.N.
825 PALMILLA DR
MODESTO, CA 95356-1152
Phone number: 209-572-3243
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Mailing Address
Mr. KIM DALE GOODRUM R.N.
825 PALMILLA DR
MODESTO, CA 95356-1152
Phone number: 209-572-3243
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