MEDICARE: ALEXIS D KNIGHT

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	225700000X	Massage Therapist	7230	NM

General Provider Information

NPI Number	:	1548761703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS D KNIGHT

Provider Business Mailing Address
First Line	:	6911 TAYLOR RANCH RD NW STE C8
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-2962
Country	:	US
Telephone Number	:	505-792-3311
Fax Number	:

Provider Business Practice Location Address
First Line	:	6911 TAYLOR RANCH RD NW STE C8
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-2962
Country	:	US
Telephone Number	:	505-792-3311
Fax Number	:	505-792-3312

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

Provider Enumeration Date	:	02/23/2018
Last Update Date	:	11/20/2020

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Directions to “ ALEXIS D KNIGHT ” Practice Location

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