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1104151331
LIZA M GOOSSENS
COVINGTON, TN
NPI
1104151331
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TN 4557)
Enumeration Date
2009-10-06
Last Update Date
2009-10-06
Business Address
Ms. LIZA M GOOSSENS PTA
765 BERT JOHNSTON AVE
COVINGTON, TN 38019-2414
Phone number: 901-475-0027
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Mailing Address
Ms. LIZA M GOOSSENS PTA
63 COMANCHE DR
MILLINGTON, TN 38053-1015
Phone number: 901-262-1383
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