Provider Demographics
NPI:1992294300
Name:KNYCH CHIROPRACTIC CORP
Entity type:Organization
Organization Name:KNYCH CHIROPRACTIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KNYCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:707-448-3008
Mailing Address - Street 1:595 BUCK AVE STE C
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-3642
Mailing Address - Country:US
Mailing Address - Phone:707-448-3008
Mailing Address - Fax:707-448-6402
Practice Address - Street 1:595 BUCK AVE STE C
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-3642
Practice Address - Country:US
Practice Address - Phone:707-448-3008
Practice Address - Fax:707-448-6402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty