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Individual

MICHAEL L GOFORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AUD

Contact information

Practice address
3400 OLD MILTON PKWY, BLDG C, STE 575, ALPHARETTA, GA 30005-3707
(770) 410-0202
(770) 410-0955
Mailing address
7215 COMMONS CIR UNIT C, CHEYENNE, WY 82009-2666
(307) 637-7415

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AUD004125
GA
237600000X
Audiologist-Hearing Aid Fitter
A-1012
WY

Other

Enumeration date
10/10/2016
Last updated
05/18/2020
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