Healthcare Provider Details

I. General information

NPI: 1891736328
Provider Name (Legal Business Name): KENNETH D KNOX D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 08/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12200 TECH RD STE. 104
SILVER SPRING MD
20904-1983
US

IV. Provider business mailing address

PO BOX 228
ASHBURN VA
20146-0228
US

V. Phone/Fax

Practice location:
  • Phone: 301-622-9000
  • Fax: 301-622-1961
Mailing address:
  • Phone: 630-401-0958
  • Fax: 301-622-1961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038-010179
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberS03662
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: