Individual
AMANDA GOUGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2240 ADAMS AVE, OGDEN, UT 84401-1511
(801) 393-5355
(801) 394-4609
Mailing address
950 N CUTLER DR APT 631, NORTH SALT LAKE, UT 84054-5066
(801) 725-2591
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
IN MAIL
UT
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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