Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PTH3832 5584 | AL |
NPI | 1447233135 |
---|---|
Provider Name | Ms. Mariafe Godbey |
First Address | Hatchechubbee, AL 36858-2808 |
Second Address | Phenix City, AL 36867-5027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P55750 | (02) | AL |