Individual ProviderMary Ann KoenigPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2200 N Canton Center Rd Ste 150, Canton, MI 48187-5037(734) 981-9410PECOS EnrollmentBased on the most recent information from CMS, provider Mary Ann Koenig does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1548486442Provider TypeIndividualFull NameKoenig, Mary AnnCredentialPTGenderFemaleSole ProprietorNoEnumeration Date4/18/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address2200 N Canton Center Rd Ste 150, Canton, MI 48187-5037Phone(734) 981-9410Fax(734) 981-9444Mailing LocationMailing Address10827 Aqua Ln, South Lyon, MI 48178-9593PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense5501003792MichiganProvider IdentifiersIDDescriptionIssuerIDOH25877DescriptionOtherIssuerBCBSMMichigan