MEDICARE: DR. WILLIAM LEROY KNOP III DC

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	2646	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326031147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM LEROY KNOP III DC

Provider Business Mailing Address
First Line	:	450 W MAPLE ST
Second Line	:	STE 1
City	:	HARTVILLE
State	:	OH
Zip	:	44632-9649
Country	:	US
Telephone Number	:	330-877-2203
Fax Number	:	330-877-7750

Provider Business Practice Location Address
First Line	:	450 W MAPLE ST
Second Line	:	STE 1
City	:	HARTVILLE
State	:	OH
Zip	:	44632-9649
Country	:	US
Telephone Number	:	330-877-2203
Fax Number	:	330-877-7750

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	07/08/2007

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