Healthcare Provider Details

I. General information

NPI: 1376001602
Provider Name (Legal Business Name): ZACHARY MICHAEL KNIGHT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2019
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10373 HIGHWAY 90 UNIT D
LITTLE RIVER SC
29566-6776
US

IV. Provider business mailing address

10373 HIGHWAY 90 UNIT D
LITTLE RIVER SC
29566-6776
US

V. Phone/Fax

Practice location:
  • Phone: 563-212-5858
  • Fax:
Mailing address:
  • Phone: 563-212-5858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number095712
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: