Most Relevant Information
Provider Data
| NPI Number: | 1003449315 |
| Provider Name: | CAITLIN LAINE KOCH LAT, ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/14/2020 |
| Last Updated: | 05/04/2023 |
Provider Practice Location
19230 POPLAR TRAILS LN
TOMBALL
TX
773751768
Practice Location Phone/Fax
| Phone: | 8322478622 |
| Fax: |
Provider Mailing Location
19230 POPLAR TRAILS LN
TOMBALL
TX
773751768
Provider Mailing Phone/Fax
| Phone: | 8322478622 |
| Fax: |