Individual
FRANK JAY KOUCHICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1210 1ST ST W, HASTINGS, MN 55033-1147
(651) 438-1800
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2253
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
990025000
—
MN
Enumeration date
04/03/2006
Last updated
03/11/2021
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