Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 2406 | MA |
Y | 213ES0103X | Foot & Ankle Surgery | 2406 | MA |
NPI | 1174862643 |
---|---|
Provider Name | Dr. Amy Kotouch |
First Address | Fall River, MA 02720-5923 |
Second Address | Fall River, MA 02720-5923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2013 |
Last Update Date | 07/11/2014 |