Individual
MRS. ELISE EVA GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6000 FAYETTEVILLE RD, DURHAM, NC 27713-9754
(336) 213-0674
Mailing address
6 WINDSONG DR, PITTSBORO, NC 27312-5755
(336) 213-0674
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1265560
NC
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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