Individual
BRADY GOOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1450 E FAIRVIEW AVE # 201, MERIDIAN, ID 83642-1819
(208) 887-6757
Mailing address
3639 S GEKELER LN APT 83, BOISE, ID 83706-6456
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6171077
ID
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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