Healthcare Provider Details

I. General information

NPI: 1972603736
Provider Name (Legal Business Name): ROYAL KNIGHT INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 11/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 HARBOR DR SE SUITE - 100
ROCHESTER MN
55904-5923
US

IV. Provider business mailing address

1204 HARBOR DR SE SUITE - 100
ROCHESTER MN
55904-5923
US

V. Phone/Fax

Practice location:
  • Phone: 507-289-8192
  • Fax: 507-289-8192
Mailing address:
  • Phone: 507-289-8192
  • Fax: 507-289-8192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name: MS. WENDY LOU JONES
Title or Position: PRESIDENT
Credential: M.S.
Phone: 507-289-8192