Individual
MR. KEVIN FITZGERALD GOODGAME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
4205 ARBOR GATES DR NE, ATLANTA, GA 30324-5615
(213) 804-0727
Mailing address
4205 ARBOR GATES DR NE, ATLANTA, GA 30324-5615
(213) 804-0727
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT24148
CA
225100000X
Physical Therapist
Primary
PT8220
GA
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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