Individual
JILL MCGOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1255 MILL RD, ANGLETON, TX 77515-7392
(770) 354-6926
Mailing address
1255 MILL RD, ANGLETON, TX 77515-7392
(770) 354-6926
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN069452
GA
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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