NPI 1124110002

John C Koth, MPT

Practitioner Physical Therapist Ketchum, ID

Practice location

Address: 101 Saddle Road, Ketchum, ID 83340-1510
Phone: (208) 726-9222
Fax: (208) 726-1607
Mailing address: PO Box 1510, Ketchum, ID 83340-1510

Registered specialties (3)

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence RPT614 (ID)

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Registry record

NPI: 1124110002
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Sep 2006
Record last updated: 17 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.