Individual
NICOLE NICHELLE KOENIGSHOF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
624 W LINCOLN AVE, GOSHEN, IN 46526-2416
(574) 931-2801
(574) 971-8569
Mailing address
4251 LAHMEYER RD, FORT WAYNE, IN 46815-5676
(260) 482-7800
(260) 484-0273
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05011693A
IN
Other
Enumeration date
11/30/2007
Last updated
01/08/2024
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