Provider Demographics
NPI:1508876533
Name:MCKNIGHT, ROBERT SEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SEAN
Last Name:MCKNIGHT
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 1:619 S BLUFF ST
Mailing Address - Street 2:TOWER 1, SUITE 400
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3853
Mailing Address - Country:US
Mailing Address - Phone:435-656-0234
Mailing Address - Fax:435-656-2622
Practice Address - Street 1:619 S BLUFF ST
Practice Address - Street 2:TOWER 1, SUITE 400
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3853
Practice Address - Country:US
Practice Address - Phone:435-656-0234
Practice Address - Fax:435-656-2622
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5052399-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT870395551005Medicaid
UTU89113Medicare UPIN