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Individual

RAYMOND ARTHUR COUTURE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
#594 LICENSED DISPEN

Contact information

Practice address
1007 FARMINGTON AVENUE, SUITE 16, WEST HARTFORD, CT 06107-2107
(860) 232-7616
(860) 233-4565
Mailing address
1007 FARMINGTON AVE, SUITE 16, WEST HARTFORD, CT 06107-2717
(860) 232-7616
(413) 572-1308

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
1270
MA
156FX1800X
Optician
Primary
594
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004036968
CT
Enumeration date
02/16/2007
Last updated
02/05/2009
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