Individual
MRS. HAZEL YVETTE KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.A.
Contact information
Practice address
148 WATERMAN STREET, PROVIDENCE, RI 02906
(401) 864-5453
Mailing address
148 WATERMAN STREET, PROVIDENCE, RI 02906
(401) 864-5453
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
DA00350
RI
Other
Enumeration date
05/06/2010
Last updated
05/06/2010
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