NPI 1407264419

Koch Chiropractic Clinic LLC

Organisation Preferred Provider Organization Imperial, NE

Practice location

Address: 441 Broadway, Imperial, NE 69033-3162
Phone: (308) 882-5532
Mailing address: P.O. Box 696, Imperial, NE 69033-0696

Authorised official

Name: Daniel Koch
Title: Organizer and Authorized Rep.
Phone: (308) 882-5532

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 1800 (NE)

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Registry record

NPI: 1407264419
Entity type: Organization
NPI issued: 23 Jul 2014
Record last updated: 23 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.