Individual
JEREMY GOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2153 E JOYCE BLVD, SUITE 201, FAYETTEVILLE, AR 72703-4714
(479) 575-9471
Mailing address
2153 E JOYCE BLVD, SUITE 201, FAYETTEVILLE, AR 72703-4714
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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