Provider Demographics
NPI:1790323236
Name:KOENIG, STEVEN WILLIAM (DPT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:WILLIAM
Last Name:KOENIG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1534 FAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2140
Mailing Address - Country:US
Mailing Address - Phone:610-223-4756
Mailing Address - Fax:
Practice Address - Street 1:440 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:MYERSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17067-2239
Practice Address - Country:US
Practice Address - Phone:717-866-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028210225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist