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General NPI Number Information
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NPI Number | 1740823822
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Entity Type | Individual
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Provider Name | JORDAN THERON KNIEFF ND
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Gender | Male
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 14525 HIGHWAY 7 STE 375
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City | MINNETONKA
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State | MN
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Zip | 55345-3741
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Country | US
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Telephone | 320-348-7424
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Fax |
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Provider Business Mailing Address
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Address Line | 14414 STEWART LN APT 414
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City | MINNETONKA
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State | MN
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Zip | 55345-5876
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Country | US
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Telephone | 320-630-0352
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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 | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 1107
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License Number State | MN
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