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General NPI Number Information
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NPI Number | 1770429920
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Entity Type | Individual
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Provider Name | JACK KNOWLES
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Gender |
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 90 US HIGHWAY 206 STE 10C
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City | STANHOPE
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State | NJ
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Zip | 07874-3128
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Country | US
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Telephone | 973-500-4340
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Fax |
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Provider Business Mailing Address
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Address Line | 4 HEMLOCK CT
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City | HACKETTSTOWN
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State | NJ
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Zip | 07840-4149
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA02384000
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License Number State | NJ
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