Individual
PETER JOHN KOERNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
9741 E WASHINGTON ST, INDIANAPOLIS, IN 46229-3035
(317) 869-0975
Mailing address
10110 TWO NOTCH RD, COLUMBIA, SC 29223-4383
(803) 365-9024
(803) 788-4899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18003767A
IN
152W00000X
Optometrist
Primary
1806
SC
Other
Enumeration date
03/04/2013
Last updated
04/04/2019
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