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NPI Code Detail

MEDICARE: JOANNE GOULET PT

MEDICARE: JOANNE GOULET PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT8181FL

General Provider Information

NPI Number : 1497921159
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNE GOULET PT
Provider Business Mailing Address
First Line : 1722 KINGSWOOD RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-5429
Country : US
Telephone Number : 904-374-9323
Fax Number :
Provider Business Practice Location Address
First Line : 1320 ROBERTS DR
Second Line :
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-3253
Country : US
Telephone Number : 904-627-1480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2008
Last Update Date : 02/14/2012

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Directions to “ JOANNE GOULET PT” Practice Location

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