NPI 1073067765 · live from the CMS NPI Registry
Jacob Edward Gough
Massage Therapist in Washington, DC. National Provider Identifier 1073067765, active.
NPI record
| NPI | 1073067765 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 1330 U St Nw, #300, Washington, DC 20009 |
| Practice phone | 202-888-5595 |
| Enumerated | August 10, 2016 |
| Last updated | August 10, 2016 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | MT1418 (DC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.