Individual
MRS. EMILY JANE KOENEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1350 S RANDOLPH ST, GARRETT, IN 46738-1971
(260) 553-9200
Mailing address
7430 CLINGMANS TRL, FORT WAYNE, IN 46835-1418
(269) 929-8111
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26022154A
IN
183500000X
Pharmacist
5302034007
MI
Other
Enumeration date
01/08/2020
Last updated
01/08/2020
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