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Individual
DEMARTEZ LAMAR COUCH
Active
Individual
DEMARTEZ LAMAR COUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
007496483
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7496483
HOME HELP PROVIDER NUMBER
—
Enumeration date
11/24/2015
Last updated
11/24/2015
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