MEDICARE: ANTHONY KOCH HHP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172M00000X	Mechanotherapist	26687	OR

General Provider Information

NPI Number	:	1235935065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY KOCH HHP

Provider Business Mailing Address
First Line	:	1524 MCCLELLAN DR
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-4146
Country	:	US
Telephone Number	:	541-591-5968
Fax Number	:

Provider Business Practice Location Address
First Line	:	2650 WASHBURN WAY UNIT 260
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-4591
Country	:	US
Telephone Number	:	541-591-5968
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2025
Last Update Date	:	02/21/2025

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