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General NPI Number Information
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NPI Number | 1902122500
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Entity Type | Organization
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Legal Business Name | JOHN GOETZE PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 04/08/2010
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Last Update Date | 04/08/2010
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Provider Practice Location Address
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Address Line | 2344 3RD ST S
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4023
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Country | US
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Telephone | 904-249-1200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8847
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City | FLEMING ISLAND
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State | FL
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Zip | 32006-0019
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN GOETZE
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Credential |
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Telephone | 904-421-2119
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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 |
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License Number State |
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