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General NPI Number Information
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NPI Number | 1861469116
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Entity Type | Individual
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Provider Name | ALBERT STEVEN GOFFINETT II ATC
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Gender | Male
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 1997 MIAMISBURG CENTERVILLE RD
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City | DAYTON
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State | OH
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Zip | 45459-3811
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Country | US
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Telephone | 937-439-6109
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Fax | 937-439-6240
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Provider Business Mailing Address
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Address Line | 1436 BIRCH BARK CT
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City | DAYTON
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State | OH
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Zip | 45440-4053
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Country | US
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Telephone | 937-848-9294
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | AT 000812
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License Number State | OH
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