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1629317516
SAMUEL JOSEPH GOUGH
MELBOURNE, FL
NPI
1629317516
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: FL PTA14486)
Enumeration Date
2013-02-12
Last Update Date
2013-02-12
Business Address
Mr. SAMUEL JOSEPH GOUGH PTA
3033 SARNO RD
MELBOURNE, FL 32934-7229
Phone number: 321-242-6812
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Mailing Address
Mr. SAMUEL JOSEPH GOUGH PTA
825 ARTHUR ST SE
PALM BAY, FL 32909-3756
Phone number: 321-514-5129
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