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Andrea M Goyette
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NPI Number Detailed Information
Provider Information:
| Name: | Andrea M Goyette |
| Gender: | F |
| Provider License Number If Given: | 2259 |
NPI Information:
| NPI: | 1841299120 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/19/2005 |
| Last Update Date: | 7/13/2007 |
Provider Business Mailing Address:
| Address: | 117 N GARTH AVE Columbia, MO 65203 |
| Phone Number: | 5734432204 |
| Fax Number: | 5738755851 |
Provider Business Practice Location Address:
| Address: | 301 N GARTH AVE Columbia, MO 65203 |
| Phone Number: | 5734493953 |
| Fax Number: | 5738743189 |
Provider Taxonomy:
| Primary: | 101Y00000X |
| Secondary (if any): | |
| State: | MO |
