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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. AMANDA DIANNE GOUGH, MS, ATC

Active

MRS. AMANDA DIANNE GOUGH, MS, ATC is a Athletic Trainer healthcare provider located in CHARLESTON, Illinois. NPI 1710213178 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · CHARLESTON, IL

Registration Details

NPI Number
1710213178
Provider Type
Individual
Gender
Female
NPI Issued
Oct 20, 2009 (16.774889439551 yrs)
Last Updated
Oct 20, 2009
License
096.002672 (IL)

Practice Information

Address
25 W LINCOLN AVE
CHARLESTON, IL, 619203070
Browse IL providers · Browse ZIP 61920
Phone
2173459600
Primary Specialty
Athletic Trainer
2255A2300X

Other Athletic Trainer Providers in CHARLESTON, IL

Name Credential NPI
LEE ANN PRICE ATC 1659344240
MRS. JENNIFER LYNN STASKIEWICZ ATC 1487774212
GINGER CANDICE SOUTH ATC 1952529307
MRS. TIFFANY LOUISE GREEN ATC 1558635219
HEIDI J MCKEAN ATC 1770835027
NATHAN DAVID SCHWARTZKOPF ATC 1104243385
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.