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General NPI Number Information
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NPI Number | 1093694937
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Entity Type | Individual
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Provider Name | ALEXANDER KNELL
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Gender | Male
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 15400 NORTHLINE RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-2689
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Country | US
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Telephone | 734-285-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 3246 S MARGARETTE CT
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City | TRENTON
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State | MI
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Zip | 48183-2308
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Country | US
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Telephone |
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 5502008876
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License Number State | MI
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