Provider Demographics
NPI:1255884789
Name:KOENIG, ROBIN (DC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
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 1:4120 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:864-226-0124
Mailing Address - Fax:864-231-9227
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:864-226-0124
Practice Address - Fax:864-231-9227
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDC4170111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor