Mountain Trail Medical

NPI #1760956924 in Rawlins, Wyoming

Provider Information

NPI Number: 1760956924
Entity Type: Organization
Organization Name: Mountain Trail Medical
Primary Specialty: Family Medicine
Enumeration Date: Jan 21, 2019
Last Updated: Nov 29, 2023

Practice Location

Address: 542 16TH ST
City: Rawlins
State: Wyoming
ZIP Code: 82301-5241
Phone: (307) 324-2759

Authorized Official

Name: DR. MARVIN WAYNE COUCH II, MD
Title: PRESIDENT/OWNER
Phone: (307) 320-7075

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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