MEDICARE: JOHN WRIGHT GOODRICH PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	1436	NC

General Provider Information

NPI Number	:	1558550947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN WRIGHT GOODRICH PT

Provider Business Mailing Address
First Line	:	232 BOONE HEIGHTS DR
Second Line	:
City	:	BOONE
State	:	NC
Zip	:	28607-4926
Country	:	US
Telephone Number	:	828-268-9043
Fax Number	:	828-268-9045

Provider Business Practice Location Address
First Line	:	232 BOONE HEIGHTS DR
Second Line	:
City	:	BOONE
State	:	NC
Zip	:	28607-4926
Country	:	US
Telephone Number	:	828-268-9043
Fax Number	:	828-268-9045

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2007
Last Update Date	:	10/22/2007

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Directions to “ JOHN WRIGHT GOODRICH PT” Practice Location

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