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NPI Code Detail

MEDICARE: BRETT AARON KOEHN DPT

MEDICARE: BRETT AARON KOEHN DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2017035064MO

General Provider Information

NPI Number : 1669981080
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRETT AARON KOEHN DPT
Provider Business Mailing Address
First Line : PO BOX 9163
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65801-9163
Country : US
Telephone Number : 417-889-4800
Fax Number : 417-889-0980
Provider Business Practice Location Address
First Line : 2017 W WOODLAND ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-5913
Country : US
Telephone Number : 417-889-4800
Fax Number : 417-889-4800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2017
Last Update Date : 09/28/2017

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