Individual
JENNIFER A KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
57 SEA SPRAY AVE, NIANTIC, CT 06357-3337
(860) 739-0861
Mailing address
57 SEA SPRAY AVE, NIANTIC, CT 06357-3337
(860) 739-0861
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
08708
CT
Other
Enumeration date
04/13/2008
Last updated
04/13/2008
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