Individual
JEFFREY KOONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1684 EDGERTON ST, MAPLEWOOD, MN 55117-2419
(612) 414-2332
Mailing address
1684 EDGERTON ST, MAPLEWOOD, MN 55117-2419
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
174221-5
MN
Other
Enumeration date
11/12/2016
Last updated
11/12/2016
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