MEDICARE: AMY MARIE GOEHNER 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
1	225100000X	Physical Therapist	6611	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	282PIGO	OTHER	MN	BCBS

General Provider Information

NPI Number	:	1851499222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY MARIE GOEHNER PT

Provider Business Mailing Address
First Line	:	20810 ODELL CT N
Second Line	:
City	:	SCANDIA
State	:	MN
Zip	:	55073-6400
Country	:	US
Telephone Number	:	651-538-0590
Fax Number	:	651-927-0450

Provider Business Practice Location Address
First Line	:	168 LAKE ST S STE C
Second Line	:
City	:	FOREST LAKE
State	:	MN
Zip	:	55025-2676
Country	:	US
Telephone Number	:	651-538-0590
Fax Number	:	651-927-0450

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	02/06/2026

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Directions to “ AMY MARIE GOEHNER PT” Practice Location

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