Individual
NICHOLAS LEO KOSHUTA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2820 N GLASSFORD HILL RD, STE 101, PRESCOTT VALLEY, AZ 86314-2256
(928) 775-5606
(928) 772-4999
Mailing address
2820 N GLASSFORD HILL RD, STE 101, PRESCOTT VALLEY, AZ 86314-2256
(928) 775-5606
(928) 772-4999
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1264
AZ
Other
Enumeration date
06/21/2005
Last updated
07/08/2007
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