Provider Demographics
NPI:1801964937
Name:GOOD, CORIE MICHELLE (DPT)
Entity type:Individual
Prefix:
First Name:CORIE
Middle Name:MICHELLE
Last Name:GOOD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CORIE
Other - Middle Name:MICHELLE
Other - Last Name:CORTEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1385 S. COLORADO BLVD.
Mailing Address - Street 2:BLDG. A, SUITE 620
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3324
Mailing Address - Country:US
Mailing Address - Phone:303-691-3733
Mailing Address - Fax:303-691-1142
Practice Address - Street 1:5801 S QUEBEC ST
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2003
Practice Address - Country:US
Practice Address - Phone:303-770-0870
Practice Address - Fax:303-770-0871
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL. 0010167225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO346693YM65Medicare PIN