Provider Demographics
NPI:1366459901
Name:MCKNIGHT, CHRISTINE MARGARET (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MARGARET
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6860
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95502-6860
Mailing Address - Country:US
Mailing Address - Phone:707-443-3384
Mailing Address - Fax:707-443-3204
Practice Address - Street 1:801 CRESCENT WAY STE 4
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6781
Practice Address - Country:US
Practice Address - Phone:707-407-0536
Practice Address - Fax:707-822-2877
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT22808225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OPT228080Medicare ID - Type Unspecified