MEDICARE: MS. LAURA LEE KNIGHT DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305202071	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	304078	OTHER	VA	ANTHEM

General Provider Information

NPI Number	:	1033178470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA LEE KNIGHT DPT

Provider Business Mailing Address
First Line	:	8002 DISCOVERY DR
Second Line	:	SUITE 410
City	:	RICHMOND
State	:	VA
Zip	:	23229-8601
Country	:	US
Telephone Number	:	804-288-0399
Fax Number	:

Provider Business Practice Location Address
First Line	:	9930 INDEPENDENCE PARK DR
Second Line	:	SUITE 101
City	:	RICHMOND
State	:	VA
Zip	:	23233-1476
Country	:	US
Telephone Number	:	804-726-2600
Fax Number	:	804-864-3819

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	11/28/2007

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