Individual
MR. CODY GOHLKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
4625 BOAT CLUB RD, FORT WORTH, TX 76135-7022
(817) 238-9295
(817) 238-9299
Mailing address
6037 HARRIS PKWY, FORT WORTH, TX 76132-4103
(817) 370-9891
(817) 370-9894
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1239610
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192079501
—
TX
Enumeration date
04/10/2014
Last updated
04/10/2014
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