Provider Demographics
NPI:1750629580
Name:KOEN, AARON CHRISTOPHER (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:CHRISTOPHER
Last Name:KOEN
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 STILLWATER BLVD N
Mailing Address - Street 2:104A
Mailing Address - City:LAKE ELMO
Mailing Address - State:MN
Mailing Address - Zip Code:55042-9603
Mailing Address - Country:US
Mailing Address - Phone:651-260-3378
Mailing Address - Fax:
Practice Address - Street 1:11200 STILLWATER BLVD N
Practice Address - Street 2:104A
Practice Address - City:LAKE ELMO
Practice Address - State:MN
Practice Address - Zip Code:55042-9603
Practice Address - Country:US
Practice Address - Phone:651-260-3378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist