Koch, Gina M.

Koch, Gina M. is an sole proprietor health care provider with primary practice located at 1990 Godfrey Dr , Waupaca WI 54981-7908. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Koch, Gina M. can be contacted via phone (715) 256-9616.

Contact Information

Primary practice address
1990 Godfrey Dr Waupaca WI 54981-7908
Fax: (715) 256-9618
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 3449-012 Wisconsin

Profile Details

NPI number 1053366203
LBN Legal business name Koch, Gina M.
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2006
Last updated Apr 11th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053366203 NPPES
Wisconsin MEDICAID 38902900

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