MEDICARE: DSVK PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1689208415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DSVK PLLC

Provider Business Mailing Address
First Line	:	521 MONTGOMERY HWY STE 121
Second Line	:
City	:	VESTAVIA HILLS
State	:	AL
Zip	:	35216-1876
Country	:	US
Telephone Number	:	205-734-0911
Fax Number	:	205-734-0913

Provider Business Practice Location Address
First Line	:	521 MONTGOMERY HWY STE 121
Second Line	:
City	:	VESTAVIA HILLS
State	:	AL
Zip	:	35216-1876
Country	:	US
Telephone Number	:	205-734-0911
Fax Number	:	205-734-0913

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. DUSTIN SPENSER KNICKREHM
Credential	:	DC
Telephone Number	:	205-706-7963

Provider Enumeration Date	:	03/02/2020
Last Update Date	:	11/03/2020

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Directions to “DSVK PLLC ” Practice Location

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