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General NPI Number Information
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NPI Number | 1558152629
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Entity Type | Individual
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Provider Name | ANNA GOOD PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 6437 OLD MONROE RD STE E
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-5415
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Country | US
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Telephone | 704-686-7767
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Fax |
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Provider Business Mailing Address
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Address Line | 1916 PUDDING LN
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City | WAXHAW
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State | NC
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Zip | 28173-6946
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Country | US
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Telephone | 828-474-4242
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 24030
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License Number State | NC
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