Provider Demographics
NPI:1194104067
Name:GOOCH, MARSHA (LMT)
Entity type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:
Last Name:GOOCH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17246 FM 2613
Mailing Address - Street 2:
Mailing Address - City:KEMP
Mailing Address - State:TX
Mailing Address - Zip Code:75143-5822
Mailing Address - Country:US
Mailing Address - Phone:903-288-7336
Mailing Address - Fax:903-498-6685
Practice Address - Street 1:229 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GUN BARREL CITY
Practice Address - State:TX
Practice Address - Zip Code:75156-3822
Practice Address - Country:US
Practice Address - Phone:903-288-7336
Practice Address - Fax:903-498-6685
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT011155225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist