Provider Demographics
NPI:1487128245
Name:KNOWLTON, ZACHARY JOHN-STEVEN (DC)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:JOHN-STEVEN
Last Name:KNOWLTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 ELM LN
Mailing Address - Street 2:
Mailing Address - City:SISTERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26175-9779
Mailing Address - Country:US
Mailing Address - Phone:304-771-3737
Mailing Address - Fax:
Practice Address - Street 1:901 N STATE ROUTE 2 STE 1
Practice Address - Street 2:
Practice Address - City:NEW MARTINSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26155-2560
Practice Address - Country:US
Practice Address - Phone:304-455-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1100111N00000X
IN08003075A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor