Individual
KATHARYN KOUCHNERKAVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2361 VALLEYWOOD DR SE APT N4, GRAND RAPIDS, MI 49546-5743
(616) 438-5848
Mailing address
2361 VALLEYWOOD DR SE APT N4, GRAND RAPIDS, MI 49546-5743
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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