Individual
JACK KOENEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
209 S CLARK ST, FOREST CITY, IA 50436-1810
(641) 582-4625
(641) 582-5510
Mailing address
209 S CLARK ST, FOREST CITY, IA 50436-1810
(641) 582-4625
(641) 582-5510
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
04849
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0200857
—
IA
01
—
20085
WELLMARK
IA
01
—
6503
MIDLANDS CHOICE
IA
Enumeration date
11/13/2006
Last updated
07/08/2007
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