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General NPI Number Information
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NPI Number | 1295856797
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Entity Type | Individual
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Provider Name | MICHAEL DENNIS KNAPP PTA
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Gender | Male
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 512 SAYBROOK RD
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City | MIDDLETOWN
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State | CT
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Zip | 06457-4788
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Country | US
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Telephone | 860-343-5997
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Fax | 860-343-6042
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Provider Business Mailing Address
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Address Line | 475 NEIPSIC RD
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City | GLASTONBURY
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State | CT
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Zip | 06033-2452
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Country | US
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Telephone | 860-983-4524
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Fax | 860-430-9762
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 000938
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 000354
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License Number State | CT
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