Individual
POLLY A KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
324 LIBERTY STREET, DELTA, MO 63744
(573) 794-2500
(573) 794-2504
Mailing address
PO BOX 787, DELTA, MO 63744-0787
(573) 794-2500
(573) 794-2504
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
114678
MO
Other
Enumeration date
11/05/2008
Last updated
11/05/2008
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