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General NPI Number Information
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NPI Number | 1811531932
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Entity Type | Individual
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Provider Name | JOSEPH IMLER-KNISELY RN
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Gender | Male
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Dates
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Enumeration Date | 10/31/2019
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Last Update Date | 10/31/2019
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Provider Practice Location Address
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Address Line | 1311 12TH AVE
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City | ALTOONA
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State | PA
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Zip | 16601-3307
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Country | US
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Telephone | 814-943-2273
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Fax | 814-942-8021
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Provider Business Mailing Address
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Address Line | 1311 12TH AVE
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City | ALTOONA
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State | PA
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Zip | 16601-3307
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Country | US
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Telephone | 814-943-2273
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Fax | 814-942-8021
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN513669L
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License Number State | PA
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