| NPI | 1467526491 |
|---|---|
| Former Name | NICOLE J KOCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 2028) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NE 2028) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NE 2028) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2024-08-01 |