Individual
SEAN GOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 W SMITH AVE, OSHKOSH, WI 54901-1848
(920) 424-7000
Mailing address
1214 STEAD DR, MENASHA, WI 54952-2191
(763) 313-6341
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2425-39
WI
2255A2300X
Athletic Trainer
2431
MN
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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