Provider Demographics
NPI:1184823387
Name:KOEHLER, CHERYL LYNNE
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNNE
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30649 SPRINGLAND ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4674
Mailing Address - Country:US
Mailing Address - Phone:248-819-7093
Mailing Address - Fax:
Practice Address - Street 1:30649 SPRINGLAND ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4674
Practice Address - Country:US
Practice Address - Phone:248-819-7093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist