Individual
KURT KOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
232 S WOODS MILL RD, CHESTERFIELD, MO 63017
(314) 205-6917
Mailing address
55 WESTPORT PLZ, STE 300, SAINT LOUIS, MO 63146-3109
(314) 548-4706
(314) 548-4747
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
070178
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
912804572
—
MO
Enumeration date
10/14/2006
Last updated
09/08/2008
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