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Individual
DR. LISA M KOCH
Active
Individual
DR. LISA M KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AU.D.
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
0158
KY
231H00000X
Audiologist
A0291
WV
231H00000X
Audiologist
Primary
A0320
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311090322
FEIN 311090322
—
Enumeration date
03/27/2013
Last updated
03/27/2013
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