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Individual

DANIEL GOSHORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1368 AMERICAN WAY, BEDFORD, VA 24523-2940
(540) 587-8612
Mailing address
29 CHASE DR APT 103, FOREST, VA 24551-3109
(814) 599-7407

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-006404
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0110-006404
COMMONWEALTH OF VIRGINIA BOARD OF MEDICINE
VA
Enumeration date
09/20/2018
Last updated
09/20/2018
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