Provider Demographics
NPI:1821259813
Name:GOETZ, AARON B (DPT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:B
Last Name:GOETZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-743-1703
Mailing Address - Fax:570-743-1728
Practice Address - Street 1:660 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:17557-1410
Practice Address - Country:US
Practice Address - Phone:717-354-7977
Practice Address - Fax:717-354-3985
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6856225100000X
PAPT019315225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021539970001Medicaid