Individual
JACK JAMES KOERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
STUDENT
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(844) 280-0777
Mailing address
1301 S GILBERT ST # 35, IOWA CITY, IA 52240-4509
(920) 246-6417
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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