Provider Demographics
NPI:1306390216
Name:KOENIG FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:KOENIG FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOENIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-473-9570
Mailing Address - Street 1:4120 CLEMSON BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1176
Mailing Address - Country:US
Mailing Address - Phone:864-226-0214
Mailing Address - Fax:
Practice Address - Street 1:4120 CLEMSON BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1176
Practice Address - Country:US
Practice Address - Phone:864-226-0214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDC4170111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1255884789OtherINDIVIDUAL NPI