Individual
KYLE S KOONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1339 N 6TH ST, COLUMBUS, OH 43201-2505
(614) 446-3622
Mailing address
1339 N 6TH ST, COLUMBUS, OH 43201-2505
(614) 446-3622
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0105201
—
OH
Enumeration date
08/08/2014
Last updated
10/15/2019
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