Individual
KYM KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3004 W LAWRENCE ST, APPLETON, WI 54914-4231
(920) 205-3764
Mailing address
3004 W LAWRENCE ST, APPLETON, WI 54914-4231
(920) 252-3549
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
158303
WI
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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