Most Relevant Information
Provider Data
| NPI Number: | 1003589383 |
| Provider Name: | CLARA MICHELLE GOODMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 8716 |
Most Important Dates
| Enumeration Date: | 07/31/2021 |
| Last Updated: | 08/01/2023 |
Provider Practice Location
3530 S VAL VISTA DR STE C101
GILBERT
AZ
852977318
Practice Location Phone/Fax
| Phone: | 6024910703 |
| Fax: | 8336611781 |
Provider Mailing Location
840 E MCKELLIPS RD STE 105
MESA
AZ
852039654
Provider Mailing Phone/Fax
| Phone: | 6024910703 |
| Fax: | 4806310581 |