Individual
MR. ROBERT ANTHONY KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.P.C.
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
—
0Q25076
BCBSM
MI
01
—
4504093
AETNA
MI
01
—
C7938
M-CARE
MI
05
—
T33835
—
MI
Enumeration date
09/27/2006
Last updated
08/19/2007
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