Healthcare Provider Details
I. General information
NPI: 1326013277
Provider Name (Legal Business Name): ADAM BRETT KNOTTS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/22/2006
Last Update Date: 09/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
204 W WATER ST
PAINTED POST NY
14870-1131
US
IV. Provider business mailing address
204 W WATER ST
PAINTED POST NY
14870-1131
US
V. Phone/Fax
- Phone: 607-936-4106
- Fax: 607-936-1559
- Phone: 607-962-3501
- Fax: 607-936-1559
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 70011190 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: