Provider Demographics
NPI:1275840696
Name:KNOFF, JAMIE LEE (MS, RPT)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:LEE
Last Name:KNOFF
Suffix:
Gender:F
Credentials:MS, RPT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:MERRITT
Other - Last Name:KNOFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, RPT
Mailing Address - Street 1:2505 LA MACARENA AVENUE
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009
Mailing Address - Country:US
Mailing Address - Phone:203-451-5430
Mailing Address - Fax:
Practice Address - Street 1:2505 LA MACARENA AVENUE
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009
Practice Address - Country:US
Practice Address - Phone:203-451-5430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36888225100000X
CT004696225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist