Krutak, Jon R.

Krutak, Jon R. is an sole proprietor health care provider with primary practice located at 4924 Fort Henry Dr Suite E, Kingsport TN 37663-3386. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Krutak, Jon R. can be contacted via phone (423) 239-7340.

Contact Information

Primary practice address
4924 Fort Henry Dr Suite E Kingsport TN 37663-3386
Phone: (423) 239-7340
Fax: (423) 239-7452
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X DC1096 Tennessee

Profile Details

NPI number 1033177365
LBN Legal business name Krutak, Jon R.
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 3rd, 2006
Last updated Mar 11th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033177365 NPPES
Tennessee MEDICAID 3676970
Tennessee Other 3058747
Tennessee Other TN0102
Tennessee Other P00441207
Tennessee Other TN0104
Tennessee Other 4324698

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