Provider Demographics
NPI:1376198184
Name:GOOD, ERIK LAWRENCE
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:LAWRENCE
Last Name:GOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ERIK
Other - Middle Name:
Other - Last Name:GOOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2080 S HOLLY ST UNIT 22652
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3027
Mailing Address - Country:US
Mailing Address - Phone:720-317-9958
Mailing Address - Fax:
Practice Address - Street 1:3041 S GRAPE WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6809
Practice Address - Country:US
Practice Address - Phone:720-317-9958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies