Individual
DR. CARRIE JEAN KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1128 DUFF AVE, AMES, IA 50010-3014
(515) 239-4460
(515) 956-4145
Mailing address
1128 DUFF AVE, AMES, IA 50010-3014
(515) 239-4460
(515) 239-4437
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002178
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0215749
—
IA
Enumeration date
10/24/2005
Last updated
11/13/2020
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