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Individual

KAYLA H KOCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1900 JEANWOOD DR, ELKHART, IN 46514-4769
(574) 264-1183
Mailing address
121 N OAKLEY AVE, MISHAWAKA, IN 46544-3886
(574) 276-3342

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001685A
IN

Other

Enumeration date
01/24/2018
Last updated
01/24/2018
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