Liza M Goossens PTA

NPI 1104151331 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1104151331
Gender Female
Enumeration Date 10/06/2009
Last Updated 10/06/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
765 BERT JOHNSTON AVE
COVINGTON TN, 38019-2414, US
Phone (901) 475-0027
Fax
Business Location
63 COMANCHE DR
MILLINGTON TN, 38053-1015, US
Phone (901) 262-1383
Fax
Toxanomy
Taxonomy Code 225200000X
License State Tennessee
License Number 4557
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According to our database, Ms. Liza M Goossens PTA NPI is 1104151331, taxonomy code is 225200000X and license number is 4557, license state is located at Tennessee. Liza M Goossens PTA physically located at 765 Bert Johnston Ave, Covington TN, 38019-2414. NPI Number Liza M Goossens PTA has the Individual type.

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1104151331 NPI number is provided on an as is basis without warranty of any kind. 1104151331 is maintained by the National Plan & Provider Enumeration System. The contents of Liza M Goossens PTA are for informational purposes only.