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NPI Code Detail

MEDICARE: DAVID KOENTOP

MEDICARE: DAVID KOENTOP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NN0400XNeurology ChiropractorCHIR009216GA

General Provider Information

NPI Number : 1851790018
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID KOENTOP
Provider Business Mailing Address
First Line : 1950 ROSWELL RD
Second Line : APT 12A4
City : MARIETTA
State : GA
Zip : 30068-3060
Country : US
Telephone Number : 732-267-2073
Fax Number :
Provider Business Practice Location Address
First Line : 1269 BARCLAY CIR SE
Second Line : LIFE UNIVERSITY: LUSSI
City : MARIETTA
State : GA
Zip : 30060-2903
Country : US
Telephone Number : 732-267-2073
Fax Number :
Authorized Official
Title or Position : DOCTOR OF CHIROPRACTIC
Name : DR. DAVID KOENTOP
Credential : D.C.
Telephone Number : 732-267-2073
Provider Enumeration Date : 08/13/2014
Last Update Date : 08/13/2014

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Directions to “DAVID KOENTOP ” Practice Location

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