Provider Demographics
NPI:1225313059
Name:KNETZER, NEIL BRETT (DC)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:BRETT
Last Name:KNETZER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 GROVE RD
Mailing Address - Street 2:SUITE M-108
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-1691
Mailing Address - Country:US
Mailing Address - Phone:412-805-0586
Mailing Address - Fax:
Practice Address - Street 1:5301 GROVE RD
Practice Address - Street 2:SUITE M-108
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-1691
Practice Address - Country:US
Practice Address - Phone:412-885-3533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor