1174656888 NPI number — MRS. JULIE CHRISTINE KNISS PT

Table of content: MRS. JULIE CHRISTINE KNISS PT (NPI 1174656888)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174656888 NPI number — MRS. JULIE CHRISTINE KNISS PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNISS
Provider First Name:
JULIE
Provider Middle Name:
CHRISTINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAIN
Provider Other First Name:
JULIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174656888
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5215 WINDROW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKVALE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37153
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-898-7236
Provider Business Mailing Address Fax Number:
615-220-8829

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 STONE CREST BLVD
Provider Second Line Business Practice Location Address:
SUITE 375 FELTZ THERAPY SERVICES
Provider Business Practice Location Address City Name:
SMYRNA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37167
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-220-5796
Provider Business Practice Location Address Fax Number:
615-220-8829
Provider Enumeration Date:
03/13/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  5936 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)