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Individual

SHANNON KOENIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT, CLT

Contact information

Practice address
6601 LYNDALE AVE S STE 105, RICHFIELD, MN 55423-2490
(612) 775-5190
Mailing address
3155 COACHMAN RD APT 387, EAGAN, MN 55121-1812

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10927
MN
225100000X
Physical Therapist
10927

Other

Enumeration date
12/20/2019
Last updated
06/14/2023
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