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1891213336
CHANTELLE TANYA KOCH
GRAND RAPIDS, MI
NPI
1891213336
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601008328)
Enumeration Date
2017-09-05
Last Update Date
2021-02-25
Business Address
Mrs. CHANTELLE TANYA KOCH PA-C
145 MICHIGAN ST NE STE 5500
GRAND RAPIDS, MI 49503-2565
Phone number: 616-267-8540
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Mailing Address
Mrs. CHANTELLE TANYA KOCH PA-C
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number:
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