Individual
MIKAELA JEAN KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
513 3RD ST SW, WAGNER, SD 57380-9675
(605) 384-3418
(605) 384-5240
Mailing address
513 3RD ST SW, WAGNER, SD 57380-9675
(605) 384-3418
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11242
SD
Other
Enumeration date
04/27/2015
Last updated
10/16/2023
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