Individual
MRS. JAIME GOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT, PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20842
MA
225100000X
Physical Therapist
PT02648
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110121031A
—
MA
01
—
12109
LICENSE#
NC
01
—
1801
LICENSE#
AK
Enumeration date
05/01/2007
Last updated
11/02/2022
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