Individual
LINDA SUSAN GOGL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, OCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0015230
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT200960
BLUE SHIELD OF CALIFORNIA
CA
01
—
0PT200961
MEDICARE PTAN
CA
05
—
1134103013
—
CO
Enumeration date
12/03/2005
Last updated
09/11/2018
Update your record
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