Provider Demographics
NPI:1285402578
Name:CORRECTIVE CHIROPRACTIC KNOXVILLE
Entity type:Organization
Organization Name:CORRECTIVE CHIROPRACTIC KNOXVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWBER
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-712-6202
Mailing Address - Street 1:220 ZEBLIN RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2050
Mailing Address - Country:US
Mailing Address - Phone:770-712-6202
Mailing Address - Fax:
Practice Address - Street 1:5400 CLINTON HWY STE 105
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-3444
Practice Address - Country:US
Practice Address - Phone:865-315-7479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COHEN CHIROPRACTIC CENTRE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty