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General NPI Number Information
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NPI Number | 1487526190
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Entity Type | Individual
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Provider Name | KYLER KNICELEY
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Gender | Male
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1618 MAIN ST
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City | CLIFTON FORGE
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State | VA
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Zip | 24422-1904
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Country | US
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Telephone | 540-691-2010
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Fax |
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Provider Business Mailing Address
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Address Line | 94 YMCA WAY APT 413
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City | COVINGTON
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State | VA
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Zip | 24426-6394
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202223149
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License Number State | VA
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