Individual
MICHAEL DEREK GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6930 OSPREY RIDGE DR, LITHIA, FL 33547-3915
(813) 478-5711
Mailing address
3016 RIDGE VALE CIR, VALRICO, FL 33596-5649
(813) 478-5711
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA47607
FL
Other
Enumeration date
05/23/2009
Last updated
05/23/2009
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