Provider Demographics
NPI:1447632054
Name:GOETSCH, TROY
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:
Last Name:GOETSCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5561 S 48TH ST STE 215E
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-4139
Mailing Address - Country:US
Mailing Address - Phone:402-566-8400
Mailing Address - Fax:
Practice Address - Street 1:5561 S 48TH ST STE 215E
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-4139
Practice Address - Country:US
Practice Address - Phone:402-566-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist