Individual
MR. STEVEN GEORGE KOENECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
5071 KIPLING ST, WHEAT RIDGE, CO 80033-2251
(303) 209-1849
(303) 209-1849
Mailing address
5071 KIPLING ST, WHEAT RIDGE, CO 80033-2251
(303) 209-1849
(303) 209-1849
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10144
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10144
PHARMACY LICENSE NUMBER
CO
Enumeration date
06/13/2011
Last updated
06/13/2011
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