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General NPI Number Information
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NPI Number | 1770663239
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Entity Type | Organization
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Legal Business Name | LOOKOUT VALLEY CHIROPRACTIC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 11/30/2010
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Provider Practice Location Address
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Address Line | 3536 CUMMINGS HWY STE120
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City | CHATTANOOGA
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State | TN
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Zip | 37419-2435
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Country | US
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Telephone | 423-825-5252
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Fax | 423-825-1228
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Provider Business Mailing Address
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Address Line | 3536 CUMMINGS HWY STE120
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City | CHATTANOOGA
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State | TN
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Zip | 37419-2435
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Country | US
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Telephone | 423-825-5252
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Fax | 423-825-1228
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | MR. NEIL J KJOS
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Credential | D.C.
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Telephone | 423-825-5252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 1430
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License Number State | TN
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