Goodall, Fay Allen
Goodall, Fay Allen is an sole proprietor health care provider with primary practice located at 185 W 4Th Ave Ste C, Post Falls ID 83854-4979. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Goodall, Fay Allen can be contacted via phone (208) 457-8746.Contact Information
Primary practice address
185 W 4Th Ave Ste C
Post Falls ID 83854-4979
Phone: (208) 457-8746
Fax: (208) 457-8767
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT00002838 | Washington |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT 10062 | California |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT-286 | Idaho |
Profile Details
| NPI number | 1730300518 |
|---|---|
| LBN Legal business name | Goodall, Fay Allen |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 1st, 2007 |
| Last updated | Apr 26th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730300518 | NPPES |
| Idaho | MEDICAID | 002609200 | |
| Idaho | Other | 82040818683854A003 | |
| Idaho | Other | 000010019002 | |
| Idaho | Other | 4004 | |
| Idaho | Other | T-5345 | |
| Idaho | Other | 2937 |
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