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Individual

MR. FRANKIE JOE COUCH JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MBS

Contact information

Practice address
301 N HIGH ST, ANTLERS, OK 74523-2238
(580) 298-5779
Mailing address
1100 N GABBART RD, STRINGTOWN, OK 74569-9055
(580) 239-2367

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100750190M
OK
Enumeration date
07/02/2010
Last updated
07/02/2010
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