Individual
MISS SHANNON LEIGH MCGOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8901 WISCONSIN AVE, BETHESDA, MD 20889-5600
(301) 295-1359
(301) 295-0326
Mailing address
453 COLLEGE PKWY, ROCKVILLE, MD 20850-1127
(240) 477-5282
(130) 129-5032
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
11/13/2009
Last updated
11/13/2009
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