Healthcare Provider Details

I. General information

NPI: 1750626040
Provider Name (Legal Business Name): A WELL ADJUSTED KOENIG CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2012
Last Update Date: 07/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8251 PINE RD SUITE 100
CINCINNATI OH
45236-2191
US

IV. Provider business mailing address

5743 RUTLEDGE TRL
LIBERTY TWP OH
45011-1245
US

V. Phone/Fax

Practice location:
  • Phone: 513-241-4230
  • Fax: 513-241-4066
Mailing address:
  • Phone: 513-519-7021
  • Fax: 513-299-0542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2177
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL HANCOCK
Title or Position: OWNER
Credential:
Phone: 513-519-7021