Maya S Gough
Maya S Gough is an Athletic Trainer in Star, Idaho. Practices as a sole proprietor. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
10284 W Virginia City StStar, ID 83669-5619
Phone: (208) 284-4922
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Athletic Trainer (primary) | Taxonomy 2255A2300X |
|---|
Record details
| NPI number | 1942824545 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | May 31, 2020 |
| Last updated in NPPES | May 31, 2020 |
| Certification date | May 31, 2020 |
| Mailing address | 10284 W Virginia City St, Star, ID 83669-5619 |
Other providers in Star
-
Carole Jane Milstead
10539 W Snow Wolf Dr, Star, ID 83669-5891 · (907) 775-2571