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General NPI Number Information
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NPI Number | 1073788402
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Entity Type | Organization
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Legal Business Name | JOANNE A. GOLUCH, INC.
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Dates
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Enumeration Date | 04/27/2008
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Last Update Date | 04/27/2008
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Provider Practice Location Address
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Address Line | 266 COUNTY ROAD 3027
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City | EUREKA SPRINGS
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State | AR
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Zip | 72632-9721
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Country | US
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Telephone | 479-253-1815
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Fax | 479-363-0000
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Provider Business Mailing Address
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Address Line | 266 COUNTY ROAD 3027
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City | EUREKA SPRINGS
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State | AR
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Zip | 72632-9721
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Country | US
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Telephone | 479-253-1815
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Fax | 479-363-0000
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/PRESIDENT
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Name | MS. JOANNE A. GOLUCH
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Credential | PT
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Telephone | 479-253-1815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 2620
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License Number State | AR
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