Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 51099 | AZ |
NPI | 1154620714 |
---|---|
Provider Name | Dr. Christopher E. Couch |
First Address | Phoenix, AZ 85013-3420 |
Second Address | Phoenix, AZ 85013-3420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2011 |
Last Update Date | 18/10/2016 |