Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MICHAEL GOEDECKE, MS ATC LAT
Active Sole ProprietorMR. MICHAEL GOEDECKE, MS ATC LAT is a Athletic Trainer healthcare provider located in TAHLEQUAH, Oklahoma. NPI 1962818914 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · TAHLEQUAH, OK
Registration Details
- NPI Number
- 1962818914
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 9, 2014 (12.057220145562 yrs)
- Last Updated
- Apr 11, 2017
- License
-
957 (OK)
- Sole Proprietor
- Yes
Practice Information
- Address
-
603 N GRAND AVETAHLEQUAH, OK, 744642302Browse OK providers · Browse ZIP 74464
- Phone
- 9184443921
- Fax
- 9184443954
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in TAHLEQUAH, OK
| Name | Credential | NPI |
|---|---|---|
| MR. RODNEY THOMAS LECHTENBERG JR. | ATC, LAT | 1619964582 |
| MR. ZACHARY DANIEL COLLETT | M.S., ATC, LAT | 1932271798 |
| WESLEY GRAGG | ATC/L | 1033532635 |
| MR. JAMES BLOOMCAMP | ATC | 1063816817 |
| MS. SHANNON RAE SLAYTON | ATC, LAT | 1679950141 |
| JORDAN GONZALES | ATC, LAT | 1154708626 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.