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General NPI Number Information
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NPI Number | 1467751636
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Entity Type | Organization
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Legal Business Name | RODD KOCH PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 03/27/2011
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 32 FRANCIS DR
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City | WYNANTSKILL
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State | NY
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Zip | 12198-8781
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Country | US
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Telephone | 518-286-9021
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Fax |
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Provider Business Mailing Address
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Address Line | 32 FRANCIS DR
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City | WYNANTSKILL
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State | NY
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Zip | 12198-8781
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/ PRESIDENT
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Name | MR. RODD KOCH
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Credential |
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Telephone | 518-286-9021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 019307-1
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License Number State | NY
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