Blaine Goodman

NPI #1104483718 in Rolla, Missouri

Provider Information

NPI Number
1104483718
Entity Type
Individual
Name
Blaine Goodman
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Nurse Anesthetist, Certified Registered
Enumeration Date
May 20, 2019
Last Updated
May 20, 2019

Practice Location

Address
1000 W 10TH ST
City
Rolla
ZIP Code
65401-2905
Phone
(573) 458-8899

Specialties & Taxonomy Codes

Specialty
Nurse Anesthetist, Certified Registered

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