Individual
CHAD A KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
BLDG. 4-2817 BOX 281, FORT BRAGG, NC 28310
(910) 907-6955
Mailing address
PO BOX 72711, FORT BRAGG, NC 28307-2711
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT05504
TX
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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