Individual
DESHAWN MCGOWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20460 ANACONDA RD, FORT DRUM, NY 13602
(315) 775-8524
Mailing address
20460 ANACONDA RD, FORT DRUM, NY 13602
(315) 775-8524
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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