Search › Missouri › 101YA0400X
Wallace Goodman
NPI 1427488055 · on the registry since 2013
Practice
- Address
- 501 Highway J N
Hayti, MO 63851 - Phone
- (573) 359-2600
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2013-11-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri