Provider Demographics
NPI:1861469116
Name:GOFFINETT, ALBERT STEVEN II (ATC)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:STEVEN
Last Name:GOFFINETT
Suffix:II
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 BIRCH BARK CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45440-4053
Mailing Address - Country:US
Mailing Address - Phone:937-848-9294
Mailing Address - Fax:
Practice Address - Street 1:1997 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3811
Practice Address - Country:US
Practice Address - Phone:937-439-6109
Practice Address - Fax:937-439-6240
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT 000812174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist