Individual
MAXWELL TEAGUE KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
11160 JOLLYVILLE RD APT 704, AUSTIN, TX 78759-5573
(972) 302-7145
Mailing address
11160 JOLLYVILLE RD APT 704, AUSTIN, TX 78759-5573
(972) 302-7145
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MTI148106
TX
Other
Enumeration date
03/24/2026
Last updated
03/24/2026
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