Provider Demographics
NPI:1346628682
Name:GOBE, ADRIENNE WOOD (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:WOOD
Last Name:GOBE
Suffix:
Gender:F
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 1:1825 FORTVIEW RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7657
Mailing Address - Country:US
Mailing Address - Phone:512-892-5250
Mailing Address - Fax:
Practice Address - Street 1:1825 FORTVIEW RD
Practice Address - Street 2:SUITE 109
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7657
Practice Address - Country:US
Practice Address - Phone:512-892-5250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1253151225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist