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1417147836
NICHOLAS RYAN KOCH
FRESNO, CA
NPI
1417147836
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-08-01
Last Update Date
2007-08-01
Business Address
Mr. NICHOLAS RYAN KOCH
3707 E SHIELDS AVE
FRESNO, CA 93726-7029
Phone number: 559-229-9040
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Mailing Address
Mr. NICHOLAS RYAN KOCH
2881 HUNTINGTON BLVD APT 260
FRESNO, CA 93721-2324
Phone number: 559-903-3343
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