ZACKERY KOCH

BOLIVAR, MO
NPI1346895976
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MO  11936)
Enumeration Date2019-08-09
Last Update Date2019-08-09
Business Address
ZACKERY KOCH BA, MAADAC-I
302 W JACKSON ST
BOLIVAR, MO 65613-1931
Phone number: 417-410-7474
Mailing Address
ZACKERY KOCH BA, MAADAC-I
302 W JACKSON ST
BOLIVAR, MO 65613-1931
Phone number: 417-410-7474
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