Provider Demographics
NPI:1922679984
Name:KOENIG, HEATHER (RVS, CCC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:KOENIG
Suffix:
Gender:F
Credentials:RVS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12242 E 116TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9922
Mailing Address - Country:US
Mailing Address - Phone:317-845-1999
Mailing Address - Fax:
Practice Address - Street 1:12242 E 116TH ST STE 400
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9922
Practice Address - Country:US
Practice Address - Phone:317-845-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner