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Individual

RENEE MICHELLE KOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPTA

Contact information

Practice address
6688 MAIN ST, GLOUCESTER, VA 23061-5194
(804) 210-1555
(804) 210-1556
Mailing address
6688 MAIN ST, GLOUCESTER, VA 23061-5194
(804) 210-1555
(804) 210-1556

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602492
VA

Other

Enumeration date
06/10/2011
Last updated
06/10/2011
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