Individual
LISA LYNN KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
911 NORTHLAND DR, PRINCETON, MN 55371-2172
(763) 389-6420
Mailing address
911 NORTHLAND DR, PRINCETON, MN 55371-2172
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1627-39
WI
225X00000X
Occupational Therapist
Primary
106774
MN
Other
Enumeration date
08/20/2014
Last updated
06/07/2023
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