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Individual

RICKI KOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1011 BERK RD, LEESPORT, PA 19533-8705
(610) 376-4168
Mailing address
504 LONG RUN DR, SCHUYLKILL HAVEN, PA 17972-9339
(570) 449-9117

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
PA

Other

Enumeration date
11/30/2017
Last updated
11/30/2017
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