Healthcare Provider Details

I. General information

NPI: 1699985580
Provider Name (Legal Business Name): JONNA KOENIG P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 04/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8170 CORPORATE PARK DR STE 132
CINCINNATI OH
45242
US

IV. Provider business mailing address

8170 CORPORATE PARK DR STE 132
CINCINNATI OH
45242-3300
US

V. Phone/Fax

Practice location:
  • Phone: 513-888-8625
  • Fax:
Mailing address:
  • Phone: 513-888-8625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number011753
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number011753
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: