Provider Demographics
NPI:1497337265
Name:KNIGHT, OLIVIA R (DC)
Entity type:Individual
Prefix:MISS
First Name:OLIVIA
Middle Name:R
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4641 DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2053
Mailing Address - Country:US
Mailing Address - Phone:269-449-8484
Mailing Address - Fax:
Practice Address - Street 1:4641 DEVON AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2053
Practice Address - Country:US
Practice Address - Phone:269-449-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301011067111N00000X
FL14519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor