TANISHA GODBOLT

CHARLOTTE, NC
NPI1740871755
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy335E00000X Prosthetic/Orthotic Supplier
(Licence: CT  054857)
Enumeration Date2021-02-02
Last Update Date2022-05-19
Business Address
TANISHA GODBOLT
9147 MOSS COVE CT
CHARLOTTE, NC 28227-8703
Phone number: 832-794-7264
Mailing Address
TANISHA GODBOLT
9147 MOSS COVE CT
CHARLOTTE, NC 28227-8703
Phone number: 832-794-7264
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