Individual
JON GOUGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4390 BELLE OAKS DR, SUITE 120, NORTH CHARLESTON, SC 29405-8559
(866) 571-2700
(877) 571-2124
Mailing address
4390 BELLE OAKS DR, SUITE 120, NORTH CHARLESTON, SC 29405-8559
(866) 571-2700
(877) 571-2124
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2233
SC
Other
Enumeration date
08/18/2008
Last updated
08/18/2008
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