Crystal Wallace Goddin, PTA

NPI #1619465481 in Bushnell, Florida

Provider Information

NPI Number: 1619465481
Entity Type: Individual
Name: Crystal Wallace Goddin, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Apr 27, 2018
Last Updated: Apr 27, 2018

Practice Location

Address: 1104 N MAIN ST, BUSHNELL, FL
City: Bushnell
State: Florida
ZIP Code: 33513
Phone: (352) 568-8777

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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