Individual
LAUREN MARIE KOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 LONGWOOD AVE, HUNNEWELL BUILDING, 1ST FLOOR, BOSTON, MA 02115-5724
(617) 355-7252
Mailing address
300 LONGWOOD AVE, HUNNEWELL BUILDING, 1ST FLOOR, BOSTON, MA 02115-5724
(617) 355-7252
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA5534
MA
Other
Enumeration date
09/27/2015
Last updated
12/20/2017
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