Individual
ANDREW WILLIAM KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 301-0655
Mailing address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 301-0655
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
011275
OH
225100000X
Physical Therapist
Primary
004871
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100028250
—
KY
Enumeration date
11/22/2005
Last updated
11/06/2015
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