Individual
MAX ROBERT COUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1500 BRIDGEPORT WAY, SUFFOLK, VA 23435-1956
(217) 371-0066
Mailing address
1500 BRIDGEPORT WAY APT 212, SUFFOLK, VA 23435-1961
(217) 371-0066
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041567463
IL
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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