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General NPI Number Information
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NPI Number | 1003572397
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Entity Type | Individual
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Provider Name | MRS. JEWAL VELORE KNIGHT
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Gender | Female
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Dates
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Enumeration Date | 11/11/2021
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 3560 US HIGHWAY 301 S
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City | SMITHFIELD
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State | NC
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Zip | 27577-9495
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Country | US
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Telephone | 919-710-9895
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Fax | 919-205-1532
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Provider Business Mailing Address
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Address Line | 750 GREENLEAF RD
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City | ANGIER
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State | NC
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Zip | 27501-8106
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Country | US
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Telephone |
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Fax | 919-205-1532
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 19905
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License Number State | NC
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