Individual
TERESA LYNNE GOEDTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
27733 SCHOENHERR RD, WARREN, MI 48088-6641
(586) 427-6640
Mailing address
198 S MAIN ST, MOUNT CLEMENS, MI 48043-7917
(586) 477-1402
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502001978
MI
Other
Enumeration date
12/27/2018
Last updated
12/27/2018
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