Healthcare Provider Details

I. General information

NPI: 1952600777
Provider Name (Legal Business Name): ACTIVIZE KNOXVILLE CHIROPRACTIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2011
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

1645 DOWNTOWN WEST BLVD UNIT 34
KNOXVILLE TN
37919-5411
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 Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK ROLAND ZITT
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 865-789-2650