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1235105404
MICHAEL STEPHEN KOCH
DECATUR, IL
NPI
1235105404
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 96002099)
Enumeration Date
2006-02-27
Last Update Date
2007-07-08
Business Address
-- MICHAEL STEPHEN KOCH MS, ATC
102 W KENWOOD AVE
DECATUR, IL 62526-4300
Phone number: 217-876-6820
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Mailing Address
-- MICHAEL STEPHEN KOCH MS, ATC
3137 COLORADO DR
DECATUR, IL 62526-2332
Phone number:
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