| Doctor Name: | MS. QIANA D GOOSBY |
| NPI Number: | 1225393440 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 070014110 |
| Business Practice Address: | 300 S Wall St Kankakee, IL - 609013454 |
| Business Phone Number: | 8159357496 |
| Business Fax Number: | 8159357860 |
| Mailing Address: | 1235 N 12000e Rd, MOMENCE |
| State: | IL |
| Postal Code: | 609543889 |
| Phone Number: | 8154726358 |
| Fax Number: | |
| NPI Enumeration Date: | 07/13/2012 |
| NPI Last Update Date: | 07/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 070014110 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |