AMANDA DIANNE GOUGH

CHARLESTON, IL
NPI1710213178
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL  096.002672)
Enumeration Date2009-10-20
Last Update Date2009-10-20
Business Address
Mrs. AMANDA DIANNE GOUGH MS, ATC
25 W LINCOLN AVE
CHARLESTON, IL 61920-3070
Phone number: 217-345-9600
Mailing Address
Mrs. AMANDA DIANNE GOUGH MS, ATC
125 W JACKSON AVE
CHARLESTON, IL 61920-1814
Phone number: 618-562-2449
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