Individual
JASON JOSEPH KOENIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
715 E WESTERN RESERVE RD, POLAND, OH 44514-3358
(330) 726-3204
Mailing address
501 WOODBURY CT, CANFIELD, OH 44406-9632
(330) 842-1584
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0030593
OH
Other
Enumeration date
01/22/2022
Last updated
10/11/2024
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