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1215523915
SALLY HAINES KOCH
CHARLOTTESVILLE, VA
NPI
1215523915
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: VA 0024179671)
Enumeration Date
2020-12-16
Last Update Date
2020-12-16
Business Address
SALLY HAINES KOCH FNP-BC
675 PETER JEFFERSON PKWY STE 300
CHARLOTTESVILLE, VA 22911-8618
Phone number: 434-817-6900
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Mailing Address
SALLY HAINES KOCH FNP-BC
103 BAYLOR PL
CHARLOTTESVILLE, VA 22902-6096
Phone number:
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