Doctor Name: | TYSON A GOKEN |
NPI Number: | 1538447941 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 070018662 |
Business Practice Address: | 1337 Lily Cache Ln Bolingbrook, IL - 604904600 |
Business Phone Number: | 6302265110 |
Business Fax Number: | |
Mailing Address: | 11345 Tower Rd, LEE |
State: | IL |
Postal Code: | 605303014 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/02/2011 |
NPI Last Update Date: | 08/02/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 070018662 |
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 |