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Individual

CARL GOEHNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1177 QUAIL CT, SUITE 200, PEWAUKEE, WI 53072-3790
(262) 695-3057
Mailing address
1177 QUAIL CT, SUITE 200, PEWAUKEE, WI 53072-3790
(262) 695-3057

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12051-24
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
123CGOEHNE
WI
Enumeration date
06/27/2012
Last updated
06/17/2015
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