Individual
MR. NATHAN ALLEN KOENEGSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
597 W FOREST AVE, JACKSON, TN 38301-3935
(731) 300-4800
Mailing address
23 GIDEON CV, JACKSON, TN 38305-6936
(618) 214-3058
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0000004821
TN
Other
Enumeration date
01/03/2014
Last updated
01/03/2014
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