Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | POH000019 | PA |
N | 222Z00000X | Podiatrist | POH000019 | PA |
Y | 224P00000X | Prosthetist | PO000243 | PA |
NPI | 1235665787 |
---|---|
Provider Name | Tiffany Koehler |
First Address | Pittsburgh, PA 15238-2908 |
Second Address | Pittsburgh, PA 15238-2908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2017 |
Last Update Date | 03/05/2017 |