Provider Demographics
NPI:1366878597
Name:GOODNIGHT, ANN B (PT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:B
Last Name:GOODNIGHT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3670 SINGLE LEAF CT
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265
Mailing Address - Country:US
Mailing Address - Phone:336-902-2414
Mailing Address - Fax:
Practice Address - Street 1:3670 SINGLE LEAF CT
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-9375
Practice Address - Country:US
Practice Address - Phone:336-902-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2357225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist