Provider Demographics
NPI:1689044604
Name:REINHOLD J GOEBELER
Entity Type:Organization
Organization Name:REINHOLD J GOEBELER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:REINHOLD
Authorized Official - Middle Name:JOSEF
Authorized Official - Last Name:GOEBELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-977-4972
Mailing Address - Street 1:412 ELK VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:TODD
Mailing Address - State:NC
Mailing Address - Zip Code:28684-9342
Mailing Address - Country:US
Mailing Address - Phone:336-977-4972
Mailing Address - Fax:
Practice Address - Street 1:412 ELK VALLEY LN
Practice Address - Street 2:
Practice Address - City:TODD
Practice Address - State:NC
Practice Address - Zip Code:28684-9342
Practice Address - Country:US
Practice Address - Phone:336-977-4972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP6452225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty