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General NPI Number Information
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NPI Number | 1811909286
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Entity Type | Organization
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Legal Business Name | JODI L KNOTT CHIROPRACTOR PC
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 05/21/2013
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Provider Practice Location Address
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Address Line | 99 ROUND SWAMP RD
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City | HUNTINGTON
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State | NY
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Zip | 11743-6435
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Country | US
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Telephone | 631-692-0779
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Fax | 631-692-0783
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Provider Business Mailing Address
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Address Line | 99 ROUND SWAMP RD
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City | HUNTINGTON
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State | NY
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Zip | 11743-6435
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Country | US
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Telephone | 631-692-0779
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Fax | 631-692-0783
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Authorized Official
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Title or Position | PRES/CHIROPRACTOR
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Name | JODI L KNOTT
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Credential | DC
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Telephone | 631-692-0779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X006504
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License Number State | NY
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