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General NPI Number Information
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NPI Number | 1508110222
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Entity Type | Individual
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Provider Name | TIMOTHY JOHN KNIGHT PTA
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Gender | Male
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Dates
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Enumeration Date | 11/02/2012
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 1703 MCTUVEOUS CT
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City | THE VILLAGES
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State | FL
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Zip | 34762-6533
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Country | US
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Telephone | 610-613-2014
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Fax |
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Provider Business Mailing Address
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Address Line | 444 N 4TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19123-4124
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Country | US
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Telephone | 610-613-2014
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA32479
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License Number State | FL
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