Individual
MARY E KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2700 W 9TH AVE, OSHKOSH, WI 54904-7247
(920) 236-1850
Mailing address
2700 W 9TH AVE, OSHKOSH, WI 54904-7247
(920) 236-1850
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1831-024
WI
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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