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General NPI Number Information
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NPI Number | 1407884612
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Entity Type | Individual
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Provider Name | BRIAN CHARLES KNIGHT ATC/L
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15 N MAPLE ST
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City | AKRON
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State | OH
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Zip | 44303-2326
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Country | US
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Telephone | 330-352-2214
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Fax |
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Provider Business Mailing Address
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Address Line | 885 EMORY AVE
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City | AKRON
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State | OH
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Zip | 44310-1715
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Country | US
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Telephone | 330-633-5412
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT-001167
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License Number State | OH
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