Individual
EVAN KOHOUTEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
145 OHARA DR, RICHMOND HILL, GA 31324-7619
(208) 262-1263
Mailing address
145 OHARA DR, RICHMOND HILL, GA 31324-7619
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
N-43979
ID
Other
Enumeration date
07/20/2015
Last updated
07/20/2015
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