1912376401 NPI number — KNIGHT FAMILY CHIROPRACTIC, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912376401 NPI number — KNIGHT FAMILY CHIROPRACTIC, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KNIGHT FAMILY CHIROPRACTIC, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912376401
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4720 TRADERS WAY STE 1000
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THOMPSONS STATION
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37179-5493
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-241-0233
Provider Business Mailing Address Fax Number:
615-535-5946

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
750 OLD HICKORY BLVD BLDG 2
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
BRENTWOOD
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37027-4528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-856-1902
Provider Business Practice Location Address Fax Number:
888-447-9206
Provider Enumeration Date:
09/15/2015

Additional Information

Authorized Official

Authorized Official Last Name:
KNIGHT-NANNI
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
P
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
615-856-1902

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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