Individual
EUGENE MARTIN KOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LBSW
Contact information
Practice address
201 SHELDON BLVD SE, GRAND RAPIDS, MI 49503-4513
(616) 965-8200
(616) 242-6057
Mailing address
2401 SHARON AVE SW, WYOMING, MI 49519-2223
(616) 965-8200
(616) 242-6057
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802084210
MI
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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