Organization
ROBERT A KOCH D.C.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA ELIZABETH SNYDER (OFFICE MANAGER)
(734) 281-2400
Entity
Organization
Contact information
Practice address
14720 FORT ST, SOUTHGATE, MI 48195-1217
(734) 281-2400
(734) 281-1795
Mailing address
14720 FORT ST, SOUTHGATE, MI 48195-1217
(734) 281-2400
(734) 281-1795
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301004639
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350025410
RAILROAD MEDICARE
MI
01
—
4504093
AETNA
MI
01
—
C7938
ACN
MI
05
—
T33835
—
MI
Enumeration date
07/28/2007
Last updated
03/27/2018
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