Healthcare Provider Details

I. General information

NPI: 1730921982
Provider Name (Legal Business Name): DREW COUCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2024
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 N 10TH ST
SPEARFISH SD
57783-2203
US

IV. Provider business mailing address

2810 HILLSVIEW RD
SPEARFISH SD
57783-6088
US

V. Phone/Fax

Practice location:
  • Phone: 605-642-2716
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: