MEDICARE: AARON KNAPP DPT

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	225100000X	Physical Therapist	297961	CA

General Provider Information

NPI Number	:	1649872078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON KNAPP DPT

Provider Business Mailing Address
First Line	:	PO BOX 1475
Second Line	:	11 MANOR DRIVE
City	:	MILLBROOK
State	:	NY
Zip	:	12545
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3327 M ST STE A
Second Line	:
City	:	MERCED
State	:	CA
Zip	:	95348-2705
Country	:	US
Telephone Number	:	209-722-1030
Fax Number	:

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

Provider Enumeration Date	:	11/10/2020
Last Update Date	:	11/10/2020

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