Provider Demographics
NPI:1508190489
Name:KNIGHT, KENNETH M (DC)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:M
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 1:2811 LURLEEN B WALLACE BLVD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-3281
Mailing Address - Country:US
Mailing Address - Phone:205-339-3333
Mailing Address - Fax:205-339-2023
Practice Address - Street 1:2811 LURLEEN B WALLACE BLVD
Practice Address - Street 2:SUITE 12
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-3281
Practice Address - Country:US
Practice Address - Phone:205-339-3333
Practice Address - Fax:205-339-2023
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1090111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor