Individual
MR. MICHAEL WAYNE GOFORTH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
VIRGINIA TECH SPORTS MEDICINE, 113 MERRYMAN CENTER, BLACKSBURG, VA 24061-0001
(540) 231-7742
Mailing address
3260 GORDON DR, BLACKSBURG, VA 24060-8675
(540) 953-0266
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000314
VA
Other
Enumeration date
04/21/2006
Last updated
07/21/2022
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