Provider Demographics
NPI:1255001327
Name:ROCKY TOP CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ROCKY TOP CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:RUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:865-444-5994
Mailing Address - Street 1:5908 TOOLE DR STE EF
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4124
Mailing Address - Country:US
Mailing Address - Phone:865-444-5994
Mailing Address - Fax:865-351-5230
Practice Address - Street 1:5908 TOOLE DR STE EF
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4124
Practice Address - Country:US
Practice Address - Phone:865-444-5994
Practice Address - Fax:865-351-5230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty