Provider Demographics
NPI:1619154614
Name:KOCHER, ANDREW (PT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:KOCHER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13537 BARRETT PARKWAY DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-5899
Mailing Address - Country:US
Mailing Address - Phone:314-821-9126
Mailing Address - Fax:314-821-9142
Practice Address - Street 1:1300 VETERANS BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-2394
Practice Address - Country:US
Practice Address - Phone:636-931-2100
Practice Address - Fax:636-931-2300
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO224701511Medicare PIN
MO224701509Medicare PIN