| Doctor Name: | BRUCE LYNN KOHTZ |
| NPI Number: | 1023059565 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 785 |
| Business Practice Address: | 2810 W 35th St Kearney, NE - 688452909 |
| Business Phone Number: | 3088652570 |
| Business Fax Number: | 3088652508 |
| Mailing Address: | 2810 W 35th St, KEARNEY |
| State: | NE |
| Postal Code: | 688452909 |
| Phone Number: | 3088652570 |
| Fax Number: | 3088652508 |
| NPI Enumeration Date: | 06/08/2006 |
| NPI Last Update Date: | 07/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 785 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |