Individual
MAX W KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 INDUSTRIAL BLVD, STE 108, MANSFIELD, TX 76063-2202
(817) 453-2800
(866) 409-0273
Mailing address
603 BISCAYNE DR, MANSFIELD, TX 76063-3235
(817) 909-6293
(866) 409-0273
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Enumeration date
11/30/2007
Last updated
12/05/2007
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