Individual
MICHAELA KELLIE GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
4650 N RAINBOW BLVD, LAS VEGAS, NV 89108-5757
(702) 525-7459
Mailing address
4650 N RAINBOW BLVD, LAS VEGAS, NV 89108-5757
(702) 525-7459
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0506601
NV
Other
Enumeration date
01/04/2019
Last updated
08/15/2025
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