Provider Demographics
NPI:1437107265
Name:GOCHA, KEVIN JAMES (DC)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:JAMES
Last Name:GOCHA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 CHURCH ST.
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37083
Mailing Address - Country:US
Mailing Address - Phone:615-666-2106
Mailing Address - Fax:615-666-7909
Practice Address - Street 1:307 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:TN
Practice Address - Zip Code:37083-1607
Practice Address - Country:US
Practice Address - Phone:615-666-2106
Practice Address - Fax:615-666-7909
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000002092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor