Individual
DR. GERARD JOHN-CHARLES COUGHLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM RESIDENT
Contact information
Practice address
1600 23RD AVE, GREELEY, CO 80634-6070
(970) 810-2847
(970) 810-2820
Mailing address
1600 23RD AVE, GREELEY, CO 80634-6070
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PDT.0000615
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
01/29/2020
Last updated
05/17/2023
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