Provider Demographics
NPI:1477370153
Name:KOCHEK, KURT
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:KOCHEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2422 BURTON ST SE STE 234
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-4809
Mailing Address - Country:US
Mailing Address - Phone:334-663-0974
Mailing Address - Fax:
Practice Address - Street 1:2422 BURTON ST SE STE 234
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-4809
Practice Address - Country:US
Practice Address - Phone:616-554-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist