Individual
MATTHEW C KOENEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
933 WEST ST, GRINNELL, IA 50112-2185
(641) 236-7565
Mailing address
933 WEST ST, GRINNELL, IA 50112-2185
(641) 236-7565
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A06094
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47072
WELLMARK BCBS
IA
Enumeration date
09/05/2006
Last updated
11/12/2007
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