Individual
MS. MICHELLE GOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
460 MAIN ST, APT 2, LEWISTON, ME 04240-6755
(207) 350-9654
Mailing address
460 MAIN ST, APT 2, LEWISTON, ME 04240-6755
(207) 350-9654
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1494
ME
Other
Enumeration date
05/24/2016
Last updated
05/24/2016
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