Provider Demographics
NPI:1205274677
Name:GODSEY, LEAH CAROLINE (RDCS)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:CAROLINE
Last Name:GODSEY
Suffix:
Gender:F
Credentials:RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2001 S WOODRUFF AVE STE 12B
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-6372
Mailing Address - Country:US
Mailing Address - Phone:208-529-2498
Mailing Address - Fax:208-528-7971
Practice Address - Street 1:2001 S WOODRUFF AVE STE 12B
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-6372
Practice Address - Country:US
Practice Address - Phone:208-529-2498
Practice Address - Fax:208-528-7971
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography