Individual
MARY BETH MCGOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.T
Contact information
Practice address
2107 PARK PLAZA DR, SPRINGFIELD, TN 37172-3937
(615) 382-0500
Mailing address
1913 OLD HUMBOLDT RD, HUMBOLDT, TN 38343-8417
(731) 499-1290
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9024
TN
Other
Enumeration date
07/29/2011
Last updated
07/29/2011
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