Individual
MS. LIZA M GOOSSENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
765 BERT JOHNSTON AVE, COVINGTON, TN 38019-2414
(901) 475-0027
Mailing address
63 COMANCHE DR, MILLINGTON, TN 38053-1015
(901) 262-1383
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4557
TN
Other
Enumeration date
10/06/2009
Last updated
10/06/2009
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