Healthcare Provider Details

I. General information

NPI: 1295030559
Provider Name (Legal Business Name): PATRICK ROLAND ZITT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2011
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 DOWNTOWN WEST BLVD UNIT 34
KNOXVILLE TN
37919-5411
US

IV. Provider business mailing address

3117 INDIGO LN
KNOXVILLE TN
37921-1453
US

V. Phone/Fax

Practice location:
  • Phone: 865-789-2650
  • Fax:
Mailing address:
  • Phone: 865-789-2650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2470
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2470
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number2470
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: