Organization
KOTH THERAPY & FITNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER R KOTH PT (PT)
(301) 884-0331
Entity
Organization
Contact information
Practice address
30387 THREE NOTCH ROAD, CHARLOTTE HALL, MD 20622-3183
(301) 884-0331
(301) 472-4388
Mailing address
PO BOX 398, CHARLOTTE HALL, MD 20622-0398
(301) 884-0331
(301) 472-4388
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
458R
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2938436
AETNA
MD
01
—
LN18KO
BCBS
MD
Enumeration date
03/01/2007
Last updated
08/01/2016
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