=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508035122
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KNECHT FAMILY CHIROPRACTIC CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2008
-----------------------------------------------------
Last Update Date | 11/12/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 HAMPTON AVE STE C
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29646-2271
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-229-3409
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 201 HAMPTON AVE STE C
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29646-2271
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-229-3409
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR OF CHIROPRACTIC/PRESIDENT
-----------------------------------------------------
Name | DR. DAVID E. KNECHT JR.
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 864-229-3409
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 1585
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------