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General NPI Number Information
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NPI Number | 1447803374
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Entity Type | Individual
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Provider Name | SETH KNEEBONE PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 07/19/2019
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Last Update Date | 07/19/2019
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Provider Practice Location Address
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Address Line | 1255 LIBERTY ST
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City | REDDING
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State | CA
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Zip | 96001-0814
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Country | US
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Telephone | 530-224-2226
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Fax |
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Provider Business Mailing Address
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Address Line | 2939 DOVE ST
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City | REDDING
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State | CA
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Zip | 96001-3634
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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