Thomas Harold McGowan, MED, ATC, LAT

Individual provider Active NPI Athletic Trainer · Town and Country, MO

NPI 1124504352 · NPPES record last updated Jul 11, 2018

Key facts

NPI
1124504352
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2013003673 (MO)
Practice address
13001 N Outer 40 Rd Ste 2a
Town and Country, MO 63017-5941
Phone
(314) 324-0367
NPI assigned
Jul 11, 2018
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
2013003673MOMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2013003673 MO Yes

Addresses

Primary practice location

13001 N Outer 40 Rd Ste 2a
Town and Country, MO 63017-5941

Mailing address

8637 Brookshire LN Apt C
Saint Louis, MO 63132-4711
Phone (314) 437-6433

Other names

  • Tom McGowan Professional name

Other providers in Town and Country, MO

All providers in Town and Country, MO · Athletic Trainer in Missouri

Sources for this page

Verify at the official NPI Registry.