Most Relevant Information
Provider Data
| NPI Number: | 1003472515 |
| Provider Name: | CHRISTOPHER GOUGH |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/10/2019 |
| Last Updated: | 05/10/2019 |
Provider Practice Location
3801 JAY ST NE APT 5
WASHINGTON
DC
200191844
Practice Location Phone/Fax
| Phone: | 4436154469 |
| Fax: |
Provider Mailing Location
3801 JAY ST NE APT 5
WASHINGTON
DC
200191844
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |