Healthcare Provider Details

I. General information

NPI: 1629391701
Provider Name (Legal Business Name): ERIN D GOOCH PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2010
Last Update Date: 07/23/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

A.T. AUGUSTA MILITARY MEDICAL CENTER 9300 DEWITT LOOP
FORT BELVOIR VA
22060
US

IV. Provider business mailing address

AT AUGUSTA MILITARY MEDICAL CENTER 9300 DEWITT LOOP
FORT BELVOIR VA
22060
US

V. Phone/Fax

Practice location:
  • Phone: 571-231-2198
  • Fax:
Mailing address:
  • Phone: 571-231-2198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070017152
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: