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General NPI Number Information
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NPI Number | 1205154242
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Entity Type | Individual
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Provider Name | ROBERT C KNIGHT LMT
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Gender | Male
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Dates
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Enumeration Date | 05/15/2010
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Last Update Date | 05/15/2010
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Provider Practice Location Address
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Address Line | 16282 STATE HIGHWAY 13 SUITE F
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City | BRANSON WEST
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State | MO
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Zip | 65737-8863
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Country | US
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Telephone | 417-272-8288
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 222
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City | REEDS SPRING
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State | MO
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Zip | 65737-0222
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Country | US
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Telephone | 417-272-8288
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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 | 2004018311
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License Number State | MO
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