Healthcare Provider Details

I. General information

NPI: 1770418063
Provider Name (Legal Business Name): LUANNE GOFFNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4851 E PICKARD ST STE 2600
MT PLEASANT MI
48858-2042
US

IV. Provider business mailing address

3599 RIVERBANK TRL
MT PLEASANT MI
48858-8221
US

V. Phone/Fax

Practice location:
  • Phone: 989-775-1662
  • Fax:
Mailing address:
  • Phone: 989-621-2734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number5502008964
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: