Derek Koon
Derek Koon is a Student in an Organized Health Care Education/Training Program in Peoria, Illinois. Practices as a sole proprietor. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
530 NE Glen Oak AvePeoria, IL 61637-0001
Phone: (309) 655-2000
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1306596671 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | March 28, 2022 |
| Last updated in NPPES | March 28, 2022 |
| Certification date | March 28, 2022 |
| Mailing address | 2015 Bond Rd, Deland, FL 32720-4531 |
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