Individual
LAKEN KOONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
122 KENT PL, ALCOA, TN 37701-1947
(865) 238-6630
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0000004706
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q105475
—
TN
Enumeration date
03/31/2019
Last updated
10/22/2025
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