Healthcare Provider Details

I. General information

NPI: 1780880328
Provider Name (Legal Business Name): CATHERINE BRANEN GOFORTH P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 09/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 STEGALL LN
ASHEVILLE NC
28805-8211
US

IV. Provider business mailing address

9 STEGALL LN
ASHEVILLE NC
28805-8211
US

V. Phone/Fax

Practice location:
  • Phone: 828-989-5088
  • Fax: 828-255-5105
Mailing address:
  • Phone: 828-989-5088
  • Fax: 828-255-5105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number9660
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: