Provider Demographics
NPI:1053745869
Name:GOOD, ABIGAIL ALLISON (DPT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ALLISON
Last Name:GOOD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:ALLISON
Other - Last Name:SCHUNK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 630001
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80163-0001
Mailing Address - Country:US
Mailing Address - Phone:303-660-6493
Mailing Address - Fax:303-346-9727
Practice Address - Street 1:4735 LAURELGLEN LN
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-6928
Practice Address - Country:US
Practice Address - Phone:303-660-6493
Practice Address - Fax:303-346-9727
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-00959672251X0800X
COPTL-00127472251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPENDINGMedicaid