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General NPI Number Information
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NPI Number | 1992347652
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Entity Type | Individual
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Provider Name | MR. FRANK L KOEHNLE III
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Gender | Male
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 10/15/2019
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Provider Practice Location Address
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Address Line | 6589 N STATE ROUTE 669 NW
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City | MCCONNELSVILLE
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State | OH
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Zip | 43756-9180
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Country | US
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Telephone | 740-721-8164
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Fax |
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Provider Business Mailing Address
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Address Line | 6589 N STATE ROUTE 669 NW
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City | MCCONNELSVILLE
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State | OH
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Zip | 43756-9180
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Country | US
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Telephone | 740-721-8164
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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 | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | RQ479912
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License Number State | OH
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