Provider Demographics
NPI:1447300546
Name:GOOD, MICHAEL PAUL (PT, ATC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:PAUL
Last Name:GOOD
Suffix:
Gender:M
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3584 SPRINGHURST BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-4141
Mailing Address - Country:US
Mailing Address - Phone:502-339-4700
Mailing Address - Fax:502-339-7050
Practice Address - Street 1:3584 SPRINGHURST BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-4141
Practice Address - Country:US
Practice Address - Phone:502-339-4700
Practice Address - Fax:502-339-7050
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004070225100000X
KYAT4542255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer