Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 29241 | CA |
NPI | 1023278280 |
---|---|
Provider Name | Jennifer Goff |
First Address | Auburn, CA 95602-2468 |
Second Address | Auburn, CA 95602-2468 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 11/06/2008 |