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General NPI Number Information
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NPI Number | 1194153627
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Entity Type | Individual
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Provider Name | TIMOTHY J KNOX PT, CHT
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Gender | Male
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Dates
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Enumeration Date | 10/18/2013
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Last Update Date | 10/18/2013
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Provider Practice Location Address
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Address Line | 1700 WALNUT ST
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City | GRANITE CITY
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State | IL
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Zip | 62040-3100
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Country | US
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Telephone | 618-452-2111
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Fax | 618-225-6417
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Provider Business Mailing Address
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Address Line | 226 W JACKSON RD
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City | SAINT LOUIS
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State | MO
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Zip | 63119-3651
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Country | US
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Telephone | 314-368-0098
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Fax | 314-962-3199
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | RO684
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License Number State | MO
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