Healthcare Provider Details

I. General information

NPI: 1942013883
Provider Name (Legal Business Name): SPORT KINETIC CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 N MAIN ST
HILLSVILLE VA
24343-1434
US

IV. Provider business mailing address

309 N MAIN ST
HILLSVILLE VA
24343-1434
US

V. Phone/Fax

Practice location:
  • Phone: 276-966-5010
  • Fax:
Mailing address:
  • Phone: 276-966-5011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KATIE MCKOWN MCKOWN
Title or Position: OWNER
Credential: DC
Phone: 276-966-5011