Provider Demographics
NPI:1326031147
Name:KNOP, WILLIAM LEROY III (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEROY
Last Name:KNOP
Suffix:III
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 1:450 W MAPLE ST
Mailing Address - Street 2:STE 1
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-9649
Mailing Address - Country:US
Mailing Address - Phone:330-877-2203
Mailing Address - Fax:330-877-7750
Practice Address - Street 1:450 W MAPLE ST
Practice Address - Street 2:STE 1
Practice Address - City:HARTVILLE
Practice Address - State:OH
Practice Address - Zip Code:44632-9649
Practice Address - Country:US
Practice Address - Phone:330-877-2203
Practice Address - Fax:330-877-7750
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2057250Medicaid
KN0854341Medicare ID - Type Unspecified
U71815Medicare UPIN