Individual
DR. LISA M KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
601 6TH AVE, HUNTINGTON, WV 25701-2103
(304) 525-7221
Mailing address
601 6TH AVE, HUNTINGTON, WV 25701-2103
(304) 525-7221
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
0158
KY
231H00000X
Audiologist
A0291
WV
231H00000X
Audiologist
Primary
A0320
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311090322
FEIN 311090322
—
Enumeration date
03/27/2013
Last updated
03/27/2013
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