Maya S Gough

NPI #1942824545 in Star, Idaho

Provider Information

NPI Number
1942824545
Entity Type
Individual
Name
Maya S Gough
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Specialist/Technologist - Athletic Trainer
Enumeration Date
May 31, 2020
Last Updated
May 31, 2020

Practice Location

Address
10284 W VIRGINIA CITY ST
City
Star
State
Idaho
ZIP Code
83669-5619
Phone
(208) 284-4922

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist - Athletic TrainerAthletic Trainer

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