Provider Demographics
NPI:1083319784
Name:GOEHRING, GABRIEL WILLIAM (PT, DPT)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:WILLIAM
Last Name:GOEHRING
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 E CEDAR ST STE H
Mailing Address - Street 2:
Mailing Address - City:RAWLINS
Mailing Address - State:WY
Mailing Address - Zip Code:82301-6029
Mailing Address - Country:US
Mailing Address - Phone:307-417-0498
Mailing Address - Fax:
Practice Address - Street 1:2100 E CEDAR ST STE H
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-6029
Practice Address - Country:US
Practice Address - Phone:307-417-0498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA100901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist