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NPI 1235935354

NPI 1235935354 : KNIGHT FAMILY LEGACY LLC : LITTLE RIVER, SC

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General NPI Number Information
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    NPI Number           |    1235935354
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    Entity Type          |    Organization 
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    Legal Business Name  |    KNIGHT FAMILY LEGACY LLC 
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Dates
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    Enumeration Date     |    02/20/2025
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    Last Update Date     |    02/20/2025
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Provider Practice Location Address
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    Address Line         |    10373 HIGHWAY 90 UNIT D 
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    City                 |    LITTLE RIVER
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    State                |    SC
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    Zip                  |    29566-6776
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    Country              |    US
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    Telephone            |    843-399-2299
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10373 HIGHWAY 90 UNIT D 
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    City                 |    LITTLE RIVER
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    State                |    SC
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    Zip                  |    29566-6776
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    Country              |    US
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    Telephone            |    843-399-2299
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     ZACHARY  KNIGHT 
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    Credential           |    DC
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    Telephone            |    563-212-5858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    
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    License Number State |    
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