Individual
DR. RYAN PATRICK KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2600 GATEWAY AVE, SUITE 2, BISMARCK, ND 58503-0568
(701) 751-1161
Mailing address
2600 GATEWAY AVE, SUITE 2, BISMARCK, ND 58503-0568
(701) 751-1161
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
785
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07066-001
BCBS ND CLINIC/GROUP #
ND
01
—
30415
BCBS ND PROVIDER NUMBER
—
Enumeration date
01/15/2007
Last updated
02/29/2008
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