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Individual

MR. STEVEN M KOCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
1 UNIVERSITY CIR, MACOMB, IL 61455-1367
(309) 298-2340
Mailing address
553 RIVER RUN DR, MACOMB, IL 61455-1173
(309) 333-2860

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096002463
IL

Other

Enumeration date
09/10/2008
Last updated
09/10/2008
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