Provider Demographics
NPI:1427696863
Name:KNIGHT CHIROPRACTIC & FUNCTIONAL HEALTH PC
Entity type:Organization
Organization Name:KNIGHT CHIROPRACTIC & FUNCTIONAL HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-212-5858
Mailing Address - Street 1:1405 EAGLE RIDGE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:LE CLAIRE
Mailing Address - State:IA
Mailing Address - Zip Code:52753-9382
Mailing Address - Country:US
Mailing Address - Phone:563-212-5858
Mailing Address - Fax:
Practice Address - Street 1:1405 EAGLE RIDGE RD STE 2
Practice Address - Street 2:
Practice Address - City:LE CLAIRE
Practice Address - State:IA
Practice Address - Zip Code:52753-9382
Practice Address - Country:US
Practice Address - Phone:563-212-5858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty