Individual
KELLY COUTSOUBOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6000 KANAKANAK ROAD, MEDICAL STAFF OFFICE, DILLINGHAM, AK 99576
(907) 842-5201
Mailing address
PO BOX 130, DILLINGHAM, AK 99576-0130
(907) 842-5201
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/02/2011
Last updated
02/02/2011
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