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Individual

THOMAS KOONTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1996 EXETER RD, GERMANTOWN, TN 38138-3949
(901) 362-2800
(901) 624-9782
Mailing address
PO BOX 381408, GERMANTOWN, TN 38183-1408
(901) 362-2800
(901) 624-9782

Taxonomy

Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
DC0000001115
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3084009
BLUECROSS BLUESHIELD
TN
Enumeration date
04/06/2007
Last updated
07/08/2007
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