Individual
JENNIFER KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
209 S INDIANA AVE, MORTON, IL 61550-2627
(217) 737-0202
Mailing address
209 S INDIANA AVE, MORTON, IL 61550-2627
(217) 737-0202
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004035
IL
Other
Enumeration date
11/26/2015
Last updated
11/26/2015
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