Provider Demographics
NPI:1912133380
Name:KOCHERT, ANTHONY (PT)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:KOCHERT
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 1:121 CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-8304
Mailing Address - Country:US
Mailing Address - Phone:803-359-1551
Mailing Address - Fax:
Practice Address - Street 1:163 CHARTER OAK RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-9246
Practice Address - Country:US
Practice Address - Phone:803-359-1551
Practice Address - Fax:803-359-0362
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist