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General NPI Number Information
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NPI Number | 1609736388
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Entity Type | Individual
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Provider Name | CAMERON KOCH
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Gender | Male
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Dates
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Enumeration Date | 11/14/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 100 E MIDLAND RD
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City | AUBURN
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State | MI
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Zip | 48611-9800
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Country | US
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Telephone | 989-662-7517
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 BUTTERFIELD RD STE 1600
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1211
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Country | US
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Telephone | 866-370-8206
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501304221
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License Number State | MI
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