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1689475949
LUCAS JOHN KOENEN
IDAHO FALLS, ID
NPI
1689475949
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2025-03-22
Last Update Date
2025-03-22
Business Address
LUCAS JOHN KOENEN DO
3100 CHANNING WAY
IDAHO FALLS, ID 83404-7533
Phone number: 208-529-6111
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Mailing Address
LUCAS JOHN KOENEN DO
3100 CHANNING WAY
IDAHO FALLS, ID 83404-7533
Phone number: 208-529-6111
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