MEDICARE: DR. TAMMY SUE KOCH PT, DPT

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	225100000X	Physical Therapist	6042	NC

General Provider Information

NPI Number	:	1356493217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAMMY SUE KOCH PT, DPT

Provider Business Mailing Address
First Line	:	103 ALPINE WAY
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28805-1519
Country	:	US
Telephone Number	:	828-505-0228
Fax Number	:	828-505-0228

Provider Business Practice Location Address
First Line	:	1011 TUNNEL RD STE 240
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28805-2060
Country	:	US
Telephone Number	:	828-505-0228
Fax Number	:	860-243-6579

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

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	05/19/2011

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