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General NPI Number Information
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NPI Number | 1942218235
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Entity Type | Individual
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Provider Name | MANOHAR D KOCHE BACHELORS DEGREE OT
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3181 PRAIRIE ST SW STE 102
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City | GRANDVILLE
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State | MI
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Zip | 49418-2076
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Country | US
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Telephone | 616-249-3545
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Fax | 616-249-3549
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Provider Business Mailing Address
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Address Line | 2493 FOREST MEADOWS CT SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-7931
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Country | US
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Telephone | 616-942-8041
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201006029
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License Number State | MI
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