Individual
MARY ROSE IRENE GOGOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 N GRAND BLVD, SAINT LOUIS, MO 63103-2097
(800) 758-3678
Mailing address
10522 WINTER PARK DR, PALOS HILLS, IL 60465-1751
(708) 789-5889
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/06/2025
Last updated
11/14/2025
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