MEDICARE: ROSS ABNER KNEPP ATC

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	2255A2300X	Athletic Trainer	36003823A	IN

General Provider Information

NPI Number	:	1972312114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSS ABNER KNEPP ATC

Provider Business Mailing Address
First Line	:	9344 WYNNFIELD DR
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47725-7694
Country	:	US
Telephone Number	:	812-296-0227
Fax Number	:

Provider Business Practice Location Address
First Line	:	933 S STATE ROAD 57
Second Line	:
City	:	WASHINGTON
State	:	IN
Zip	:	47501-4374
Country	:	US
Telephone Number	:	812-202-7070
Fax Number	:

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

Provider Enumeration Date	:	01/02/2025
Last Update Date	:	01/02/2025

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Directions to “ ROSS ABNER KNEPP ATC” Practice Location

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