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General NPI Number Information
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NPI Number | 1235543067
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Entity Type | Individual
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Provider Name | BRANDI LYNN GOSS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 218 E 20TH ST STE A
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City | EUDORA
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State | KS
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Zip | 66025-7700
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Country | US
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Telephone | 785-542-3333
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Fax | 785-542-3330
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Provider Business Mailing Address
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Address Line | 1200 CORPORATE DR STE 400
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City | HOOVER
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State | AL
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Zip | 35242-5424
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Country | US
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Telephone | 423-238-7217
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305208667
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11-06387
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License Number State | KS
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