Provider Demographics
NPI:1790424067
Name:GOODMAN, ARIEL LYNNE (OD)
Entity Type:Individual
Prefix:DR
First Name:ARIEL
Middle Name:LYNNE
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:5465 GULL RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1014
Practice Address - Country:US
Practice Address - Phone:269-349-7631
Practice Address - Fax:269-349-3639
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-07-27
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Provider Licenses
StateLicense IDTaxonomies
MI4901005644152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist