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General NPI Number Information
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NPI Number | 1720057276
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Entity Type | Individual
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Provider Name | DUSTIN CRAIG KNUTSON D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 2165 ASHLEY PHOSPHATE RD SUITE A AND B
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-4157
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Country | US
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Telephone | 843-824-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 1334 SONG SPARROW WAY
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City | HANAHAN
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State | SC
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Zip | 29410-8410
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Country | US
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Telephone | 843-270-1675
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2293
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License Number State | SC
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