Provider Demographics
NPI:1427717503
Name:KOCH, ADAM JAMES (DPT)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:JAMES
Last Name:KOCH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8911 W 64TH TER APT 201
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4703
Mailing Address - Country:US
Mailing Address - Phone:785-268-0387
Mailing Address - Fax:
Practice Address - Street 1:7850 FREEMAN AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-2133
Practice Address - Country:US
Practice Address - Phone:913-334-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist