Goodhue, Shannon E

Goodhue, Shannon E is an individual health care provider with primary practice located at 8087 Washington Village Dr Ste 101 , Centerville OH 45458-1873. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Goodhue, Shannon E can be contacted via phone (937) 938-8380.

Contact Information

Primary practice address
8087 Washington Village Dr Ste 101 Centerville OH 45458-1873
Phone: (937) 938-8380
Fax: (937) 938-8392
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT011345 Ohio

Profile Details

NPI number 1275619009
LBN Legal business name Goodhue, Shannon E
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Aug 26th, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275619009 NPPES
Ohio MEDICAID 0108341
Ohio Other 382617193-30
Ohio Other 000000190966

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