Individual
MR. KURT KENNETH KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3016 W FAIDLEY AVE, GRAND ISLAND, NE 68803-4109
(308) 381-8546
(308) 381-8550
Mailing address
3016 W FAIDLEY AVE, GRAND ISLAND, NE 68803-4109
(308) 381-8546
(308) 381-8550
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
157
NE
Other
Enumeration date
02/03/2011
Last updated
02/03/2011
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