Provider Demographics
NPI:1952600777
Name:ACTIVIZE KNOXVILLE CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:ACTIVIZE KNOXVILLE CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:ROLAND
Authorized Official - Last Name:ZITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:865-789-2650
Mailing Address - Street 1:1645 DOWNTOWN WEST BLVD UNIT 34
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5411
Mailing Address - Country:US
Mailing Address - Phone:865-789-2650
Mailing Address - Fax:
Practice Address - Street 1:1645 DOWNTOWN WEST BLVD UNIT 34
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5411
Practice Address - Country:US
Practice Address - Phone:865-789-2650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty