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General NPI Number Information
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NPI Number | 1427557750
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Entity Type | Individual
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Provider Name | HEATHER JILL KOERNER AP
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Gender | Female
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 02/01/2018
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Provider Practice Location Address
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Address Line | 301 CRAWFORD BLVD STE 103
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City | BOCA RATON
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State | FL
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Zip | 33432-3762
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Country | US
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Telephone | 772-480-6578
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Fax | 772-480-6578
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Provider Business Mailing Address
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Address Line | 14146 PACIFIC POINT PL APT 105
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City | DELRAY BEACH
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State | FL
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Zip | 33484-1886
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Country | US
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Telephone | 772-480-6578
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP3883
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License Number State | FL
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