Individual
COLBY TYLER KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
22 CREE DR, LOCK HAVEN, PA 17745-2639
(570) 748-9377
Mailing address
PO BOX 523, MC ELHATTAN, PA 17748-0523
(570) 494-7343
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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