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General NPI Number Information
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NPI Number | 1265590608
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Entity Type | Individual
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Provider Name | ROGER G KNOWLES D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 12792 W. ALAMEDA PKWY., SUITE E
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City | LAKEWOOD
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State | CO
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Zip | 80228
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Country | US
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Telephone | 303-988-8823
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Fax |
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Provider Business Mailing Address
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Address Line | 220 SUNRISE AVE
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City | MEDFORD
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State | OR
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Zip | 97504-6660
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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 | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 5909
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 2281
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License Number State | CO
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