Traci Goltz, DPT

Individual provider Active NPI Physical Therapist · Greenfield, IA

NPI 1003224544 · NPPES record last updated Jul 29, 2014

Key facts

NPI
1003224544
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
005104 (IA)
Practice address
609 SE Kent St
Greenfield, IA 50849-9454
Phone
(641) 743-2123
Fax
(641) 743-7283
NPI assigned
Jul 29, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
005104IAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 005104 IA Yes
Physical Therapist 225100000X 3603 AR

Addresses

Primary practice location

609 SE Kent St
Greenfield, IA 50849-9454

Mailing address

850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070

Other providers in Greenfield, IA

All providers in Greenfield, IA · Physical Therapist in Iowa

Sources for this page

Verify at the official NPI Registry.