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NPI Code Detail

MEDICARE: ELIZABETH ANN BRODIE-KNOPE PT

MEDICARE: ELIZABETH ANN BRODIE-KNOPE PT
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
1225100000XPhysical TherapistPT00005710WA

General Provider Information

NPI Number : 1770694283
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ANN BRODIE-KNOPE PT
Provider Business Mailing Address
First Line : 1141 BEACH DR E
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-4937
Country : US
Telephone Number : 503-202-8109
Fax Number :
Provider Business Practice Location Address
First Line : 1141 BEACH DR E
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-4937
Country : US
Telephone Number : 503-202-8109
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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Directions to “ ELIZABETH ANN BRODIE-KNOPE PT” Practice Location

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