Healthcare Provider Details

I. General information

NPI: 1942280185
Provider Name (Legal Business Name): PHILLIP L. KNAPP OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2006
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11852 SHAFFER DR BUILDING M
LITTLETON CO
80127-3764
US

IV. Provider business mailing address

11852 SHAFFER DR BUILDING M
LITTLETON CO
80127-3764
US

V. Phone/Fax

Practice location:
  • Phone: 303-933-0353
  • Fax:
Mailing address:
  • Phone: 303-933-0353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number1680
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: