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Individual
JAIME MICHELLE MCGOUGH
Active
Individual
JAIME MICHELLE MCGOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT015906
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013558900001
—
PA
Enumeration date
09/30/2005
Last updated
08/27/2007
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