Individual
KATHLEEN KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1102 ERIN DR, KENT, OH 44240-2032
(330) 808-4678
Mailing address
1102 ERIN DR, KENT, OH 44240-2032
(330) 808-4678
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2281178
—
OH
Enumeration date
08/05/2014
Last updated
08/05/2014
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