Most Relevant Information
Provider Data
| NPI Number: | 1003675596 |
| Provider Name: | MATTHEW THOMAS COUSIN |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/18/2024 |
| Last Updated: | 03/18/2024 |
Provider Practice Location
6144 APPLECREEK RD
SMITHVILLE
OH
446779720
Practice Location Phone/Fax
| Phone: | 3309880046 |
| Fax: |
Provider Mailing Location
6144 APPLECREEK RD
SMITHVILLE
OH
446779720
Provider Mailing Phone/Fax
| Phone: | 3309880046 |
| Fax: |