Individual
DR. LENA GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3325 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 972-3575
Mailing address
6805 MARTIN FERRY RD, TOBACCOVILLE, NC 27050-9686
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
P11808
NC
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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