Provider Demographics
NPI:1750626040
Name:A WELL ADJUSTED KOENIG CHIROPRACTIC INC
Entity type:Organization
Organization Name:A WELL ADJUSTED KOENIG CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-519-7021
Mailing Address - Street 1:5743 RUTLEDGE TRL
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-1245
Mailing Address - Country:US
Mailing Address - Phone:513-519-7021
Mailing Address - Fax:513-299-0542
Practice Address - Street 1:8251 PINE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2191
Practice Address - Country:US
Practice Address - Phone:513-241-4230
Practice Address - Fax:513-241-4066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
OH2177111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2276460Medicaid
OH0778372Medicare PIN
OH2276460Medicaid