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General NPI Number Information
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NPI Number | 1134981178
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Entity Type | Individual
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Provider Name | MATTHEW KNIGHT CMT
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Gender | Male
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 4096 2ND AVE
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City | SACRAMENTO
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State | CA
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Zip | 95817-2154
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Country | US
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Telephone | 408-638-1993
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Fax |
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Provider Business Mailing Address
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Address Line | 817 S 3RD ST
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City | SAN JOSE
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State | CA
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Zip | 95112-5837
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Country | US
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Telephone | 408-638-1993
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 93068
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License Number State | CA
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