JUSTIN JOSEPH COUCH

BLOOMINGTON, IL
NPI1922451681
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IL  209.014394)
Enumeration Date2016-07-18
Last Update Date2016-07-18
Business Address
-- JUSTIN JOSEPH COUCH NP-C
2200 E WASHINGTON ST
BLOOMINGTON, IL 61701-4364
Phone number: 309-662-3311
Mailing Address
-- JUSTIN JOSEPH COUCH NP-C
PO BOX 608
BLOOMINGTON, IL 61702-0608
Phone number: 309-287-5394
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