NPI 1073067765

Jacob Edward Gough

Practitioner Massage Therapist Washington, DC

Practice location

Address: 1330 U St NW #300, Washington, DC 20009-7991
Phone: (202) 888-5595

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MT1418 (DC)

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Registry record

NPI: 1073067765
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Aug 2016
Record last updated: 10 Aug 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.