Provider Demographics
NPI:1376001602
Name:KNIGHT, ZACHARY MICHAEL (DC)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:MICHAEL
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 EAGLE RIDGE ROAD STE. 2
Mailing Address - Street 2:
Mailing Address - City:LECLAIRE
Mailing Address - State:IA
Mailing Address - Zip Code:52753
Mailing Address - Country:US
Mailing Address - Phone:563-729-1400
Mailing Address - Fax:563-729-1401
Practice Address - Street 1:1405 EAGLE RIDGE ROAD STE. 2
Practice Address - Street 2:
Practice Address - City:LECLAIRE
Practice Address - State:IA
Practice Address - Zip Code:52753
Practice Address - Country:US
Practice Address - Phone:563-729-1400
Practice Address - Fax:563-729-1401
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA095712111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0223789Medicaid