Provider Demographics
NPI:1467779652
Name:GOLDYN, EVA J (LMT)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:J
Last Name:GOLDYN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 SPRING CREEK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412-3959
Mailing Address - Country:US
Mailing Address - Phone:423-894-3175
Mailing Address - Fax:
Practice Address - Street 1:931 SPRING CREEK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-3959
Practice Address - Country:US
Practice Address - Phone:423-894-3175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNME0000001254174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist