Provider Demographics
NPI:1558714196
Name:GOOD, KALYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:KALYNN
Middle Name:
Last Name:GOOD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19539 HESS RD UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3890
Mailing Address - Country:US
Mailing Address - Phone:720-853-2022
Mailing Address - Fax:720-853-2022
Practice Address - Street 1:19539 HESS RD UNIT 102
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3890
Practice Address - Country:US
Practice Address - Phone:720-853-2022
Practice Address - Fax:720-853-2022
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-19
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33772TLG152W00000X, 152WP0200X, 152WV0400X
COOPT.0003372152W00000X, 152WP0200X, 152WV0400X
NJ27OA00667300152W00000X, 152WV0400X
CO3372152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty