Provider Demographics
NPI:1649082652
Name:KOENIG, SYDNEY JANE (DC)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:JANE
Last Name:KOENIG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 W MOREHEAD ST APT 240
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-5373
Mailing Address - Country:US
Mailing Address - Phone:440-537-6338
Mailing Address - Fax:
Practice Address - Street 1:6060 PIEDMONT ROW DR S STE 140
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28287-3801
Practice Address - Country:US
Practice Address - Phone:704-544-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-25
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor