NPI 1760946412

Simone Goodwyn

Practitioner Private Vehicle Suffolk, VA

Practice location

Address: 652 Carolina Rd, Suffolk, VA 23434-4870
Phone: (252) 267-9746
Mailing address: PO Box 541, Suffolk, VA 23439-0541

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X

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Registry record

NPI: 1760946412
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Jan 2019
Record last updated: 28 Jan 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.