Madison N Couch, RD | |
715 Frog Rd, Locust Grove, GA 30248-3507 | |
(678) 763-4127 | |
Not Available |
Full Name | Madison N Couch |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 715 Frog Rd, Locust Grove, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1447928304 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133V00000X | Dietitian, Registered | LD005820 (Georgia) | Primary |
Provider Name | Health Services Of Central Georgia |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1184679482 PECOS PAC ID: 9638076730 Enrollment ID: O20031217000270 |
Mailing Address | Practice Location Address |
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Madison N Couch, RD 715 Frog Rd, Locust Grove, GA 30248-3507 Ph: (678) 763-4127 | Madison N Couch, RD 715 Frog Rd, Locust Grove, GA 30248-3507 Ph: (678) 763-4127 |
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