Provider Demographics
NPI:1942688866
Name:KNOWLTON, KRISTIN LORRAINE (DC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LORRAINE
Last Name:KNOWLTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 S. PADRE ISLAND DRIVE
Mailing Address - Street 2:SUITE 13
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5161
Mailing Address - Country:US
Mailing Address - Phone:361-991-4672
Mailing Address - Fax:361-991-4673
Practice Address - Street 1:4455 S. PADRE ISLAND DRIVE
Practice Address - Street 2:SUITE 13
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5161
Practice Address - Country:US
Practice Address - Phone:361-991-4672
Practice Address - Fax:361-991-4673
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor