Individual
JANICE M GOMOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4020 RAINTREE RD STE D, CHESAPEAKE, VA 23321-3749
(757) 484-4241
(757) 484-4487
Mailing address
PO BOX 69030, BALTIMORE, MD 21264-9030
(757) 873-2302
(757) 873-2306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305002436
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010208793
—
VA
05
—
1508887597
—
VA
01
—
192941
BCBS (PHYSICAL THERAPY)
VA
01
—
7899071
AETNA
VA
01
—
P00233936
MEDICARE RR
VA
01
—
P00871013
MEDICARE RAILROAD
VA
Enumeration date
07/22/2006
Last updated
04/16/2018
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