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General NPI Number Information
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NPI Number | 1225479215
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Entity Type | Individual
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Provider Name | LAUREN GOEBBEL LAUREN GOEBBEL AT
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Gender | Female
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Dates
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Enumeration Date | 07/08/2013
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Last Update Date | 07/08/2013
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Provider Practice Location Address
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Address Line | 3584 HOME RD
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City | POWELL
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State | OH
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Zip | 43065
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Country | US
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Telephone | 740-657-4263
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Fax | 740-657-4297
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Provider Business Mailing Address
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Address Line | 3584 HOME RD
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City | POWELL
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State | OH
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Zip | 43065
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Country | US
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Telephone | 740-657-4263
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Fax | 740-657-4297
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT002490
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License Number State | OH
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