Organization
WAMSUTTER COMMUNITY HEALTH CENTER26-
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN WAYNE COUCH II MD (MEDICAL DIRECTOR)
(307) 324-6002
Entity
Organization
Contact information
Practice address
401 FULTZ DRIVE, WAMSUTTER, WY 82336
(307) 328-0468
(307) 324-9438
Mailing address
PO BOX 208, WAMSUTTER, WY 82336
(307) 328-0468
(307) 324-9438
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5629A
WY
363AM0700X
Medical Physician Assistant
Primary
279
WY
Other
Enumeration date
01/14/2010
Last updated
01/15/2010
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