Provider Demographics
NPI:1174852578
Name:KNOX, KOURTNEY JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:KOURTNEY
Middle Name:JEAN
Last Name:KNOX
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:PO BOX 1416
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-1416
Mailing Address - Country:US
Mailing Address - Phone:808-575-5483
Mailing Address - Fax:808-575-5483
Practice Address - Street 1:810 HAIKU RD
Practice Address - Street 2:SUITE 303
Practice Address - City:HAIKU
Practice Address - State:HI
Practice Address - Zip Code:96708-4803
Practice Address - Country:US
Practice Address - Phone:808-575-5483
Practice Address - Fax:808-575-5483
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR-6454111N00000X
HIDC-1209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor