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NPI Code Detail

MEDICARE: KENT KNEIP OD

MEDICARE:   KENT  KNEIP  OD
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
1152W00000XOptometrist630AZ

General Provider Information

NPI Number : 1487628095
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENT KNEIP OD
Provider Business Mailing Address
First Line : 1425 S HIGLEY RD
Second Line : #103
City : GILBERT
State : AZ
Zip : 85296-4798
Country : US
Telephone Number : 480-840-6888
Fax Number : 480-840-3361
Provider Business Practice Location Address
First Line : 1425 S HIGLEY RD
Second Line : #103
City : GILBERT
State : AZ
Zip : 85296-4798
Country : US
Telephone Number : 480-840-6888
Fax Number : 480-840-3361
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 08/06/2009

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Directions to “ KENT KNEIP OD” Practice Location

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