Individual
MRS. GRETCHEN SHAY GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT, ATC
Contact information
Practice address
350 LAFAYETTE AVE SE, GRAND RAPIDS, MI 49503-4656
(616) 456-8515
(616) 456-8208
Mailing address
5646 VIA NUEVO DR NE, ROCKFORD, MI 49341-9404
(616) 334-5812
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000770
MI
Other
Enumeration date
01/18/2015
Last updated
01/18/2015
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