EDMOND GODBOUT

PROVIDENCE, RI
NPI1710991955
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: RI  PA00090)
Enumeration Date2006-07-27
Last Update Date2010-02-19
Business Address
-- EDMOND GODBOUT PA
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-519-1604
Mailing Address
-- EDMOND GODBOUT PA
PO BOX 9484
PROVIDENCE, RI 02940-9484
Phone number: 401-854-2500
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