Provider Demographics
NPI:1427309673
Name:KOON, FLORENCE KATHERINE (LMT)
Entity type:Individual
Prefix:MISS
First Name:FLORENCE
Middle Name:KATHERINE
Last Name:KOON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 CEDAR ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1569
Mailing Address - Country:US
Mailing Address - Phone:208-255-7170
Mailing Address - Fax:208-263-9621
Practice Address - Street 1:520 CEDAR ST
Practice Address - Street 2:SUITE F
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1569
Practice Address - Country:US
Practice Address - Phone:208-255-7170
Practice Address - Fax:208-263-9621
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3155172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist