Provider Demographics
NPI:1134200728
Name:MCGOUGH, SAMMY LEE (DC)
Entity type:Individual
Prefix:DR
First Name:SAMMY
Middle Name:LEE
Last Name:MCGOUGH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 PRATT AVE NE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6317
Mailing Address - Country:US
Mailing Address - Phone:256-682-8890
Mailing Address - Fax:
Practice Address - Street 1:502 PRATT AVE NE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6317
Practice Address - Country:US
Practice Address - Phone:256-533-2900
Practice Address - Fax:256-533-1333
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2141111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor