Provider Demographics
NPI:1881838258
Name:GOETSCH, BONNIE SOULINEE (PT)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:SOULINEE
Last Name:GOETSCH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 COVAN CV
Mailing Address - Street 2:ATTN: PERFECT BALANCE
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-5518
Mailing Address - Country:US
Mailing Address - Phone:828-298-8249
Mailing Address - Fax:888-511-1844
Practice Address - Street 1:245 ROSMAN HWY
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-5708
Practice Address - Country:US
Practice Address - Phone:828-966-9036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6905225100000X
NC5600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist