Koch, Michael R.
Koch, Michael R. is an sole proprietor health care provider with primary practice located at 1948 Godfrey Dr , Waupaca WI 54981-7908. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Koch, Michael R. can be contacted via phone (715) 340-5383.Contact Information
Primary practice address
1948 Godfrey Dr
Waupaca WI 54981-7908
Phone: (715) 340-5383
Fax: (715) 258-7773
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 4135-024 | Wisconsin |
Profile Details
| NPI number | 1225058878 |
|---|---|
| LBN Legal business name | Koch, Michael R. |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2006 |
| Last updated | Oct 11th, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225058878 | NPPES |
| Wisconsin | MEDICAID | 40224600 |
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