Individual
MISS MELISSA SUE KOENIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3366 E 55TH ST, CLEVELAND, OH 44127-1638
(216) 271-1133
Mailing address
9555 GREEN VALLEY DR, MENTOR, OH 44060-6565
(440) 350-0265
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
018933
OH
Other
Enumeration date
12/01/2010
Last updated
12/01/2010
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