Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 6214-024 | WI |
N | 2251S0007X | Physical Therapist - Sports | 6214-024 | WI |
N | 2251X0800X | Physical Therapist - Orthopedic | 6214-024 | WI |
NPI | 1386707529 |
---|---|
Provider Name | Dr. Todd G Goldbeck |
First Address | Madison, WI 53719-4471 |
Second Address | Jefferson, WI 53549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 08/07/2007 |