MR. Jason Robert Gough, MS PT CBIS

NPI #1598983215 in Longview, Texas

Provider Information

NPI Number: 1598983215
Entity Type: Individual
Name: MR. Jason Robert Gough, MS PT CBIS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: MS PT CBIS
Enumeration Date: Apr 20, 2007
Last Updated: May 5, 2020

Practice Location

Address: 3202 4TH ST
City: Longview
State: Texas
ZIP Code: 75605-5217
Phone: (903) 753-6635

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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