Individual
MARANDA NAOMI KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
497 W LOTT ST, BUFFALO, WY 82834-1658
(307) 684-5521
Mailing address
PO BOX 3630, FLAGSTAFF, AZ 86003-3630
(928) 522-9879
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11323
AZ
363A00000X
Physician Assistant
Primary
PT1430
WY
Other
Enumeration date
12/06/2024
Last updated
03/04/2026
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