Provider Demographics
NPI:1366162497
Name:GOOD, CHRISTOPHER WADE
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:WADE
Last Name:GOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:CHRISTOPHER
Other - Middle Name:
Other - Last Name:GOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2828 LUKE DR
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75442-2511
Mailing Address - Country:US
Mailing Address - Phone:142-463-6962
Mailing Address - Fax:
Practice Address - Street 1:2828 LUKE DR
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75442-2511
Practice Address - Country:US
Practice Address - Phone:121-446-3696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224ZE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantEnvironmental Modification