MEDICARE: RONALD DAVID GOETSCH A.T.,C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	TE000997L	PA
2	2255A2300X	Athletic Trainer	RT000032A	PA

General Provider Information

NPI Number	:	1548204068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD DAVID GOETSCH A.T.,C.

Provider Business Mailing Address
First Line	:	402 WAVERLY TER
Second Line	:
City	:	RUTLEDGE
State	:	PA
Zip	:	19070-2138
Country	:	US
Telephone Number	:	610-543-0775
Fax Number	:

Provider Business Practice Location Address
First Line	:	217 KEDRON AVE
Second Line	:
City	:	FOLSOM
State	:	PA
Zip	:	19033-1310
Country	:	US
Telephone Number	:	610-532-2633
Fax Number	:	610-532-7856

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	09/11/2025

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