Provider Demographics
NPI:1770660094
Name:KNIGHT CHIROPRACTIC CENTER LLP
Entity Type:Organization
Organization Name:KNIGHT CHIROPRACTIC CENTER LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:585-889-3280
Mailing Address - Street 1:3313 CHILI AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-5300
Mailing Address - Country:US
Mailing Address - Phone:585-889-3280
Mailing Address - Fax:585-889-7759
Practice Address - Street 1:3313 CHILI AVE
Practice Address - Street 2:SUITE E
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-5300
Practice Address - Country:US
Practice Address - Phone:585-889-3280
Practice Address - Fax:585-889-7759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009304111N00000X
NY010213111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7682769OtherAETNA
NYG0189056590OtherBC/BS GROUP ID
NY106043ANOtherPREFERRED CARE
NY7682769OtherAETNA
NYRA9572Medicare ID - Type Unspecified