Individual
NICHOLAS N KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
8168 HIGHWAY 789, LANDER, WY 82520-2953
(307) 332-5240
(307) 332-5241
Mailing address
2002 W SUNSET DR STE 1, RIVERTON, WY 82501-2285
(307) 856-7021
(307) 856-5546
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2013
WY
Other
Enumeration date
10/07/2020
Last updated
12/17/2021
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