Healthcare Provider Details

I. General information

NPI: 1578257028
Provider Name (Legal Business Name): AARON VINCENT LOCHER RD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E 9TH ST
CORALVILLE IA
52241-2209
US

IV. Provider business mailing address

808 5TH ST APT 402
CORALVILLE IA
52241-2336
US

V. Phone/Fax

Practice location:
  • Phone: 319-467-2000
  • Fax:
Mailing address:
  • Phone: 563-580-1674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: