Individual
AMY SUSAN DE KOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2801 E MAIN ST APT 510, RICHMOND, VA 23223-7914
(707) 396-0431
Mailing address
2801 E MAIN ST APT 510, RICHMOND, VA 23223-7914
(707) 396-0431
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/30/2023
Last updated
01/30/2023
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