Dr. Paul E. Koch, Optometrist, P.c

NPI #1255574711 in Ponderay, Idaho

Provider Information

NPI Number: 1255574711
Entity Type: Organization
Organization Name: Dr. Paul E. Koch, Optometrist, P.c
Primary Specialty: Optometrist
Enumeration Date: Apr 14, 2009
Last Updated: Feb 26, 2014

Practice Location

Address: 476999 HIGHWAY 95
Address 2: C/O WALMART VISION CENTER
City: Ponderay
State: Idaho
ZIP Code: 83852-9738
Phone: (208) 255-5513

Authorized Official

Name: DR. PAUL ERWIN KOCH, O.D.
Title: PRESIDENT
Phone: (208) 290-2401

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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