Individual
INICE D GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
270 S SPRUCE, SISTERS, OR 97759
(541) 549-3583
(541) 549-3583
Mailing address
PO BOX 2178, SISTERS, OR 97759-2178
(541) 549-3583
(541) 549-3583
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27 2994
OR
Other
Enumeration date
08/30/2007
Last updated
03/17/2008
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