Individual
LISA KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
459 16TH ST APT A, DUNBAR, WV 25064-2538
(304) 539-8939
Mailing address
459 16TH ST APT A, DUNBAR, WV 25064-2538
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/25/2021
Last updated
02/25/2021
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