Individual
PAMELA R KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
721A RIVER DR, FORT BRAGG, CA 95437-5402
(707) 964-1192
(707) 964-4631
Mailing address
721 RIVER DRIVE, SUITE A, FORT BRAGG, CA 95437-0000
(707) 964-1192
(707) 964-4631
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
13556
CA
Other
Enumeration date
06/03/2010
Last updated
06/03/2010
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