Provider Demographics
NPI:1639657505
Name:KOENIG, NANCY M (DPT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:KOENIG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 APPLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-9341
Mailing Address - Country:US
Mailing Address - Phone:724-998-8745
Mailing Address - Fax:724-627-4665
Practice Address - Street 1:425 APPLE HILL RD
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-9341
Practice Address - Country:US
Practice Address - Phone:724-998-8745
Practice Address - Fax:724-627-4665
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002732E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist