Provider Demographics
NPI:1467674259
Name:KOEHLER, JOANIE (RPT)
Entity Type:Individual
Prefix:
First Name:JOANIE
Middle Name:
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 W MEADOW PASS CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1652
Mailing Address - Country:US
Mailing Address - Phone:615-896-6400
Mailing Address - Fax:
Practice Address - Street 1:704 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOPE
Practice Address - State:KS
Practice Address - Zip Code:67108-9408
Practice Address - Country:US
Practice Address - Phone:316-667-2431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1100987225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist