Individual
MS. KAY ELLEN KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL, ATP
Contact information
Practice address
296 HASCALL RD NW, ATLANTA, GA 30309-2222
(404) 875-1767
Mailing address
296 HASCALL RD NW, ATLANTA, GA 30309-2222
(404) 875-1767
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT002132
GA
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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