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Organization

MICHAEL COUCH JR DPM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL A COUCH JR. MD (OWNER & OPERATOR)
(315) 409-4165
Entity
Organization

Contact information

Practice address
4011 ARROWHEAD LN, LIVERPOOL, NY 13090-2821
(315) 409-4165
(315) 409-4165
Mailing address
PO BOX 340, NEW HARTFORD, NY 13413-0340
(315) 732-9368
(315) 732-9403

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N005821
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02165644
NY
Enumeration date
01/07/2008
Last updated
01/07/2008
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