| Tracie B Goodspeed, Llc | |
|
3941 S 1st St W Muskogee OK 74401-8915 | |
| (918) 687-3730 | |
| Not Available |
| Full Name | Tracie B Goodspeed, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3941 S 1st St W, Muskogee, Oklahoma |
| Authorized Official Name and Position | Tracie B Goodspeed (OWNER) |
| Authorized Official Contact | 9186873730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracie B Goodspeed, Llc 3941 S 1st St W Muskogee OK 74401-8915 Ph: (918) 687-3730 | Tracie B Goodspeed, Llc 3941 S 1st St W Muskogee OK 74401-8915 Ph: (918) 687-3730 |
| NPI Number | 1184993297 |
|---|---|
| Provider Enumeration Date | 12/19/2011 |
| Last Update Date | 12/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184993297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 4461 (Oklahoma) | Primary |
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