Individual
MR. CHAD KOCH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
350 MAIN ST NW, BOURBONNAIS, IL 60914-2383
(815) 936-1855
(815) 936-6097
Mailing address
336 S PRAIRIE AVE, BRADLEY, IL 60915-2139
(815) 802-0512
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
04/05/2006
Last updated
07/08/2007
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