Individual
JONATHAN EDWARD KOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
204 N CENTRAL AVE, MARSHFIELD, WI 54449-2109
(715) 898-1600
Mailing address
204 N CENTRAL AVE, MARSHFIELD, WI 54449-2109
(715) 898-1600
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2431-39
WI
Other
Enumeration date
10/07/2021
Last updated
02/16/2024
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