Provider Demographics
NPI:1477610210
Name:KOCHS ORTHOTICS AND PROSTHETICS
Entity Type:Organization
Organization Name:KOCHS ORTHOTICS AND PROSTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCELLO
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRAO
Authorized Official - Suffix:
Authorized Official - Credentials:CO-PED
Authorized Official - Phone:248-723-5452
Mailing Address - Street 1:1301 MAIN STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118
Mailing Address - Country:US
Mailing Address - Phone:734-433-2660
Mailing Address - Fax:734-433-1931
Practice Address - Street 1:1301 MAIN STREET
Practice Address - Street 2:SUITE A
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118
Practice Address - Country:US
Practice Address - Phone:734-433-2660
Practice Address - Fax:734-433-1931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI96202OtherBEAUMONT HEALTH
MIP43246OtherBLUE CARE NETWORK
MI10012OtherCARE CHOICES
530H12530OtherMESSA
MIP43246OtherBLUE CARE NETWORK