Provider Demographics
NPI:1710947015
Name:GOHEN, TERESA CHRISTINE (DC)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:CHRISTINE
Last Name:GOHEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 DEEP RUN RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:PIPERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18947-9782
Mailing Address - Country:US
Mailing Address - Phone:215-766-3073
Mailing Address - Fax:215-766-3075
Practice Address - Street 1:1806 DEEP RUN RD
Practice Address - Street 2:SUITE D
Practice Address - City:PIPERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18947-9782
Practice Address - Country:US
Practice Address - Phone:215-766-3073
Practice Address - Fax:215-766-3075
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002932L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA068616Medicare ID - Type UnspecifiedMEDICARE PROVIDER #