Individual
MR. TIMOTHY ROBERT KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 204-8627
(479) 273-8675
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716
(479) 204-8627
(479) 273-8675
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
044203
MO
Other
Enumeration date
10/15/2007
Last updated
10/15/2007
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