Individual provider · Type 1 NPI
John Mark Koucheravy, C PED
Pedorthist · Rockville, MD
NPI number
1699245365
Active
Practice location
1643 Rockville Pike Unit B
Rockville, MD 20852-7601
Mailing address
1621 Quail Run
Charlottesville, VA 22911-9054
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pedorthist Primary | 224L00000X | None listed |
Pedorthist: An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices.
Another provider at this address
About NPI 1699245365
John Mark Koucheravy, C PED's National Provider Identifier is 1699245365, issued on Nov 26, 2018. The primary taxonomy on file is Pedorthist (224L00000X), and the practice location is in Rockville, MD. The record was last updated on Nov 26, 2018.