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General NPI Number Information
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NPI Number | 1427760818
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Entity Type | Individual
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Provider Name | THOMAS DANIEL COUTURE CPS-MH
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Gender | Male
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Dates
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Enumeration Date | 12/19/2022
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Last Update Date | 12/19/2022
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Provider Practice Location Address
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Address Line | 3150 PLATAEU DRIVE LOT 303
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City | COLUMBUS
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State | GA
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Zip | 31903
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Country | US
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Telephone | 706-332-3773
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 HAMILTON RD
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City | COLUMBUS
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State | GA
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Zip | 31904-8834
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Country | US
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Telephone | 706-332-3773
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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