Individual
CHRISTOPHER KOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
30387 THREE NOTCH ROAD, CHARLOTTE HALL, CHARLOTTE HALL, MD 20622-3183
(301) 884-0331
(301) 472-4388
Mailing address
PO BOX 398, CHARLOTTE HALL, CHARLOTTE HALL, MD 20622-0398
(301) 884-0331
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19020
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403877100
—
MD
01
—
4380001
FEDERAL BCBS
MD
01
—
60728701
BCBS
MD
01
—
7261400
AETNA
MD
Enumeration date
03/01/2007
Last updated
10/29/2008
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