Michelle Renae Goreth, PTA

NPI #1558917476 in Geneseo, Illinois

Provider Information

NPI Number: 1558917476
Entity Type: Individual
Name: Michelle Renae Goreth, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Aug 15, 2019
Last Updated: Aug 15, 2019

Practice Location

Address: 719 S OAKWOOD AVE
City: Geneseo
State: Illinois
ZIP Code: 61254-1756
Phone: (563) 650-7169

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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