Individual
KYLE KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1118 N RECKER RD STE 109, MESA, AZ 85205-5540
(480) 833-2778
Mailing address
1902 E IVANHOE ST, GILBERT, AZ 85295-5160
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13323
AZ
Other
Enumeration date
08/31/2017
Last updated
08/31/2017
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